ARUP's Laboratory Test Directory

Antiphospholipid Syndrome Reflexive Panel : 2003222

Mnemonic: PHOS SYN

Ordering Recommendation: Preferred initial panel for strong suspicion of antiphospholipid syndrome (APS).
Methodology: Clotting/Semi-Quantitative Enzyme-Linked Immunosorbent Assay
Performed: Sun-Sat
Reported: 1-2 days
Specimen Required: Collect: Lt. blue (sodium citrate) for Lupus Anticoagulant Reflexive Panel (refer to the Specimen Handling at aruplab.com for hemostasis/thrombosis specimens handling guidelines) AND serum separator tube for cardiolipin and beta-2 glycoprotein antibodies.

Specimen Preparation: Transport 2 mL platelet poor plasma. (Min: 1 mL) AND 1 mL serum (Min: 0.6 mL) in two separate ARUP Standard Transport Tubes.

Storage/Transport Temperature: Plasma: CRITICAL FROZEN. Separate specimens must be submitted when mulitiple tests are ordered.
Serum: Refrigerated.

Unacceptable Conditions: For Lupus Anticoagulant Reflexive Panel (Plasma): Serum and non-sodium citrate plasma.
For cardiolipin and beta-2 glycoprotein antibodies (Serum): Plasma and other body fluids, heat-inactivated, hemolyzed, lipemic, or contaminated specimens.

Stability (collection to initiation of testing): For Lupus Anticoagulant Reflexive Panel (Plasma): Ambient: 4 hours; Refrigerated: 24 hours; Frozen: 1 week;
For cardiolipin and beta-2 glycoprotein antibodies (Serum): Ambient: 48 hours; Refrigerated: 2 weeks; Frozen 1 year (avoid repeated freeze/thaw cycles).
Reference Interval:
 
Test Number Components Reference Interval
0050321Beta-2 Glycoprotein 1 Antibodies, IgG & IgM  
 
Test Number Components Reference Interval
 Beta-2 Glycoprotein 1 Antibody, IgG Refer to report
 Beta-2 Glycoprotein 1 Antibody, IgM Refer to report
0050901Cardiolipin Antibody, IgG 0-14 GPL: Negative
15-19 GPL: Indeterminate
20-80 GPL: Low to Medium positive
81 GPL or above: High positive
0050902Cardiolipin Antibody, IgM 0-12 MPL: Negative
13-19 MPL: Indeterminate
20-80 MPL: Low to Medium Positive
81 MPL or above: High positive
0030181 Lupus Anticoagulant Reflexive Panel  
 
Test Number Components Reference Interval
 Prothrombin Time Refer to report
 Partial Thromboplastin Time Refer to report
 Dilute Russell Viper Venom Time (dRVVT) Refer to report
 Thrombin Time Refer to report
 Reptilase Time Refer to report
 PTT Heparin Neutralized Refer to report
 Partial Thromboplastin Time 1:1 Mix (performed if PTT > 48 seconds) Refer to report
 Platelet Neutralization Procedure (performed if PTT 1:1 Mix > 48 seconds) Refer to report
 Dilute Russell Viper Venom (dRVVT) 1:1 Mix (performed if dRVVT > 44 seconds) Refer to report
 Dilute Russell Viper Venom Time (dRVVT) Confirmation Test (performed if dRVVT 1:1 Mix > 44 seconds) Refer to report
 Hexagonal Phospholipid Neutralization Refer to report
Interpretive Data: See individual components.
Note: If PTT and dRVVT are normal, no further testing is performed. If PTT is abnormal, Thrombin Time is added. If Thrombin Time is normal, PTT 1:1 mix is added.  If Thrombin time is abnormal, Reptilase Time is added. If Reptilase Time is abnormal, PTT 1:1 mix is added. If Reptilase Time is normal, PTT Heparin Neutralization is added. If PTT Heparin Neutralization is abnormal, PTT 1:1 mix is added.  If PTT 1:1 mix is abnormal, Platelet Neutralization procedure is added. If dRVVT is abnormal, dRVVT 1:1 mix is added. If dRVVT 1:1 mix is abnormal, dRVVT confirmation is added. If Platelet Neutralization procedure and dRVVT confirmation are normal or if one is normal and the other not done, Hexagonal Phospholipid Neutralization is added. Additional charges may apply.
CPT Code(s): 89147 x2; 86146 x2; 85610; 85730; 85613; if reflexed, additional CPT codes may apply: 85670; 85635
Cross References: Anti-Phospholipid Syndrome Reflexive Panel (Antiphospholipid Syndrome Reflexive Panel), APS Reflexive Panel (Antiphospholipid Syndrome Reflexive Panel), Hughes Syndrome Panel (Antiphospholipid Syndrome Reflexive Panel), Hypercoag (Antiphospholipid Syndrome Reflexive Panel), Hypercoagulable (Antiphospholipid Syndrome Reflexive Panel), Thrombophilia (Antiphospholipid Syndrome Reflexive Panel)