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UW Health SMPH
American Family Children's Hospital

UW Hospital and Clinics Lab Test Directory

Test Name: Lupus Anticoagulant Work-Up

Test Code(s): LUPUS / HCLUPUS

CPT Code(s): 85730, 85347, 85613; Additional CPT codes may be added for testing-85610, 85730x2, 85732x2, 85670, 85240, 85597.

Test Description: Test Component:

Includes APTT, Kaolin Clot Time Screen and dilute Russell Viper Venom Screen.  May reflex to Protime, APTT Inhibitor Screen, Thrombin Time, Factor VIII Assay and dilute Russell Viper Venom Confirm.


Clinical Significance: May be part of hypercoagulation workup. May also be performed as a result of an elevated APTT.

Days Performed: Mon and Thurs, dayshift- specimens are accepted at any time. Testing required during off hours must be approved by a Coagulation physician. Call (608)263-5005 before collection.

Turnaround Time: Stat: 1 working day.
Routine: 4 - 7 working days.


Specimen Requirements

Specimen: Blood

Patient Preparation: Patient MUST be off heparin for at least 72 hours and off a direct thrombin inhibitor for 24 hours prior to collection.

Collection Instructions: Do NOT collect through a line containing heparin. The venipuncture MUST be atraumatic to avoid hemolysis and contamination with tissue factors and platelets. Tube must be allowed to fill completely.

Indicate if patient is receiving anticoagulant (warfarin/Heparin/Vitamin K antagonist), direct thrombin inhibitor or fibrinolytic agent therapy and duration.

Collection Container: Preferred: Light blue top (3.2% NaCitrate)

Collection Volume: Preferred: Four full 3.5 mL tubes
Pediatrics: 2 full pediatric tubes filled to mark

Sample Analyzed: Plasma

Volume Required: Preferred: 5 mL
Pediatrics: 1.5 mL

Specimen Processing: Ultracentrifuge sample and label "ULT". If an ultracentrifuge is not available, centrifuge specimen to yield platelet poor plasma (platelet count should be 10 K/L or less). Separate plasma and transfer to plastic tube and spin again. Transfer plasma from second spin to clean plastic tube or vial. Indicate on tube "spun twice". Freeze plasma within 4 hours of collection at -20C or below.

Specimen Transport: Transport whole blood specimen at room temperature to laboratory within 4 hours of collection. See Specimen Processing for instructions if transport criteria are not met. Transport frozen plasma aliquot on dry ice to UWHC Core Laboratory (B4/220).

Unacceptable Criteria: Specimens collected from patients who have received heparin within 72 hours of collection, a direct thrombin inhibitor within 24 hours of collection or rivaroxaban within 24 hours of collection are not acceptable.  Hemolyzed specimens, clotted specimens, partially filled tubes and whole blood specimens greater than 4 hours old when received by the laboratory are not acceptable.

Stability: Ambient: 4 hours on spun tube
Refrigerated: Not acceptable
Frozen: 2 weeks at -20C; 6 months at -70C


Interpretation

Expected Results:

Negative

Additional Information:

The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions. The UWHC Clinical Laboratories is authorized under Clinical Laboratory Improvement Amendments (CLIA) to perform high-complexity testing.

Lupus Anticoagulant Work-Up

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