Test
APAS Work Up
Other Test Request Name
- APS
- Anti-phospholipid antibody test
- APA test
- APLA test
- Anti-cardiolipin antibody syndrome
- aCL syndrome
- Hughes syndrome
- Lupus anticoagulant syndrome
Test Composition
• Partial Thromboplastin Time
• SCT
• DRVVT
• Anti CardiolipinIgG
• Anti CardiolipinIgM
Intended Use
• For autoimmune disorder that is associated with pregnancy.
• Anti-phospholid Antibodies Syndrome (APAS) Work up is used to determine the cause of improper blood clot formation, recurrent miscarriage, low platelet count and/or prolonged Activated Partial Thromboplastin time (APTT).
Methodology
Multi-wavelength transmitted light method
• DRVVT
• SCT
• PTT
Enzyme Link Immunosorbent Assay (ELISA)
• Anti-Cardiolipin IgM
• Anti-Cardiolipin IgG
Laboratory Section
Hematology
Special Instructions/Patient Preparations
- No patient preparation necessary.
- DO NOT use glass as collection and transport tube (for PTT, DRVV, and SCT)
Collection/Sample Container
Two (2) Citrated Blue top
• DRVVT
• SCT
• PTT
One (1) Gold top
• Anti-Cardiolipin IgG
• Anti-Cardiolipin IgM
Specimen and Volume Requirement
Note:Follow tube manufacturer recommendation.
• Plasma: at least 2mL
• Serum: at least 1 mL
Alternative Specimen and Volume Requirement
Not applicable:
• DRVVT
• SCT
• PTT
Red top:
• Anti-Cardiolipin IgG
• Anti-Cardiolipin IgM
Specimen Stability
• Room Temperature (15-25°C)
• PTT: 4 hours
• Refrigerated Temperature (2-8°C)
ACA IgG & ACA IgM: 4days
• Freezer Temperature (-20°C)
7 Days
ACA IgG & ACA IgM: >4days
Transport Temperature
• Anti-Cardiolipin IgG and IgM (Serum) – transport at 2°C to 10°C (with cold packs)
• DRVVT, SCT and PTT (Plasma)– transport at room temperature (15°C to 25°C)
NOTE:
• Sample must be sent to laboratory immediately after collection.
• Samples that cannot be sent to HPD laboratory within 4 hours should be stored at -20°C and should be transported with dry ice.
Rejection Criteria
• Improper use of anticoagulant
• Insufficient volume of blood to anticoagulant (<90% filled)
• Improperly labeled specimens
• Hemolyzed specimens
• Specimen stored and transported outside the temperature requirement
Running Day
Wednesday and Saturday
• Anti-CardiolipinIgG
• Anti-CardiolipinIgM
• DRVV
• SCT
Daily
• PTT
Cut Off Time
Wednesday and Saturday; 2:00 pm
Anti-CardiolipinIgG
Anti-CardiolipinIgM
DRVVT
SCT
Monday up to Saturday, 8:00pm
PTT
Sunday, 4:00 PM
PTT
TAT/Releasing of Results
Thursday and Sunday; 9:00 AM
- Anti-CardiolipinIgG
- Anti-CardiolipinIgM
- DRVVT
- SCT
3 hours after receipt of specimen/ messenger arrival
· PTT
Reference Interval/Result Interpretation
• APTT: 25.00-40.00Seconds
• DRVVT: 0.80-1.20
• SCT: 1.08-1.21
• Anti-Cardiolipin IgG:
NEGATIVE = <12.00 GPL-U/mL
POSITIVE = >18.00 GPL-U/mL
EQUIVOCAL = 12.00 – 18.00 GPL-U/mL
• Anti-Cardiolipin IgM:
NEGATIVE = <12.00 MPL-U/mL
POSITIVE = >18.00 MPL-U/mL
EQUIVOCAL = 12.00 – 18.00 MPL-U/mL
Limitations/Interferences
• Dysfibrinogenemia
• Heparin intake
• Intrinsic pathway deficiencies
• Presence of factor inhibitors
• Hepatic disorders
• Treatments with vitamin K antagonists
• Treatment with thrombin inhibitors
• DIC
Frequently Asked Questions (FAQs)
Not applicable
Related Words/Test
Lupus Anticoagulant Testing, Cardiolipin Antibodies, Partial Thromboplastin Time (PTT, aPTT), Beta-2 Glycoprotein 1 Antibodies, Antinuclear Antibody (ANA), Autoimmune Diseases, Excessive Clotting Disorders, Antiphospholipid Syndrome, Lupus, Pregnancy.