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Test Code INMIX Inhibitor Screen, Plasma

Important Note

PLEASE NOTE:   If possible, the patient cannot be receiving anticoagulation medication as this will interfere with test results:

  • This testing is not appropriate for patients on Rivaroxaban (Xarelto).  That medication  confounds lupus anticoagulant testing because the DRVVT is prolonged in these patients but it also corrects with excess phospholipid, mimicking a lupus anticoagulant. Patient medication review is critical to avoid false-positive findings and inappropriate diagnosis of antiphospholipid syndrome.  If possible, the patient should abstain from this medication for a minimum of 2 days prior to collection of a specimen for this test.
  • Other direct Xa inhibitors including Eliquis(apixaban) and direct thrombin inhibitors including Pradaxa (dabigatran), Acova(argatroban) also affect test results.
  • Patient should not be receiving warfarin or heparin. If the patient is currently on warfarin or heparin, this should be noted, treatment with heparin causes false-positive results of in vitro coagulation testing for lupus anticoagulant. Warfarin treatment may impair ability to detect the more subtle varieties of lupus-like anticoagulants.

Additional Codes

LAB478

Specimen Required

Container Type:

Optimal:  2- 1.8 mL light blue top tubes

Acceptable: 2- 2.7 mL solid blue top tubes

Optimal Collection Volume: 

3.6 mL whole blood

Tube must be filled to proper level as indicated by opaque line etched on each blue top tube.

Collection Instructions:

1. Do not draw from an arm with a heparin lock.

2. If collected through a blood collection set (butterfly),
a discard tube must first be drawn to eliminate dead space from tubing. 

3. Gently invert 5 to 10 times to mix blood.

4. Causes for rejection include tube under filled, clotted specimen, or sample not processed and frozen within 4 hours of collection.

Processing Instructions: 

1. Centrifuge samples in a centrifuge verifed to produce platelet poor plasma.

2. Remove plasma using platelet poor plasma technique.   

3. Aliquot each blue top tube into its own vial.  Do not pool.

4. Platelet poor plasma must be processed and frozen with 4 hours of collection.

Useful For

  • Confirming or excluding the presence of lupus anticoagulant
  • Distinguishing lupus anticoagulants from specific coagulation factor inhibitors and nonspecific inhibitors
  • Investigating a prolonged activated thromboplastin time, especially when combined with other coagulation studies

Profile Information

Test ID   Reporting Name Available Separately Always Performed
PTI Prothrombin Time Yes Yes
PTTI Activated Partial Thromboplastin Time Yes Yes
TTIMI Thrombin Time No

Yes

UFHXA Unfractionated Heparin Anti-Xa Yes Yes
LATEST Dilute Russell Vipor Venom Time (DRVVT)Screen No No
DTIME DRVVT Confirm (with additional phospholipid)) No No
RATIO DRVVT Screen/ Confirm Ratio No No
LATSTM DRVVT Screen Mix No No
DTIMEM DRVVT Confirm Mix No No
RATIOM DRVVT Screen Mix/Confirm Mix Ratio No No
RATIO DRVVT Screen/ Confirm Ratio No No
SCTS Silica Clotting Time (SCT) Screen No Yes
SCTC Silica Clotting Time (SCT) Confirm No No
SCTR SCT Screen/Confirm Ratio No No
SCTSM SCT Screen Mix No No
SCTCM SCT Confirmation Mix No No
SCTMR SCT Screen Mix/Confirm Mix Ratio No No
MXINT Mixing Study Interpretation by Pathologist No Yes
DVINT Inhibitor Path Interpretation by Pathologist No Yes

Method Name

Clot based assay performed on IL ACL Top 500

Stability Information

Specimen Type Temperature Time
Plasma Frozen within 4 hours of draw time  (-20 C) 2 weeks

Rejection Due To

Hemolysis Mild OK; Moderate OK; Gross Reject
Lipemia Mild OK; Moderate OK; Gross Reject
Icterus Mild OK; Moderate OK; Gross Reject
Other

Clotted: Reject

Sample not filled to line: Reject

 

Specimen Minimum Volume

Collecting minimum volumes can result in a need for sample recollection, and/or a delay in results. Minimum volumes are subjective and cannot account for all aspects of specimen and testing needs. Refer to the Specimen Required section for optimal volumes for laboratory specimens. Contact the Bronson Laboratory if complex collection exceptions occur that require more information.

 

Minimum Volume: Tube must be filled to line.  3.6 mL whole blood in 2 light blue top tubes.
Neonate Volume: Tube must be filled to line.  3.6 mL whole blood in 2 light blue top tubes.

Day(s) Performed

Monday, Wednesday, Friday: Day shift

Reference Values

 Test ID   Reference Range    Units      
PTI 10.5-13.0 seconds
PTTI 25-37 seconds

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PTI Prothrombin Time 5902-2
PTTI Activated Partial Thromboplastin Time 14979-9
     

CPT Code Information

Test ID Test Order Name CPT Code
PTI Prothrombin Time 85610
PTTI Activated Partial Thromboplastin Time 85730
TTIMI Thrombin Time 85670
UFHXA Unfractionated Heparin Anti-Xa 85520
PTTH APTT with Protamine Sulfate for Heparin Neutralization 85525
LATEST DRVVT Screen 85613
DTIME DRVVT Confirm 85613
MXINT Mixing Study Interp 85390-26
DVINT Inhibitor Path Interp 85390-26

Sample Retention Time

Frozen aliquots are kept for 1 month.

Performing Laboratory

Bronson Laboratory, Coagulation - Kalamazoo