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Epic Code LAB478 Lupus Screen

Important Note

Centrifuge and remove plasma within 1 hour of collection.

Patient should not be on anticoagulants when being drawn for the screen.

Interfering medications include the following:  Apixaban, (Eliquis®), Rivaroxaban, (Xarelto®), Dabigatran, (Pradaxa), and Argatroban.  Interfering medications will lead to aberrant/uninterpretable test results.  Suggest testing when patient is not on interfering medications.  

There is currently a nationwide shortage of this tube, anticipated to last through August 2021. Please take steps to ensure specimen integrity to reduce recollection. Specimen Tube Shortage (link)

Test Name Alias

Lupus Anticoagulant Screen | LA1 | Russell Viper Venom | 4134 | Lupus confirmation | LA2 | DRVVT

Interface Order Alias

10420

Clinical Information

The lupus screen is an assay used for the detection of lupus anticoagulants.  The test employs a simplified Dilute Russell’s Viper Venom DRVV reagent.  The test may be used to investigate a prolonged activated thromboplastin time. 

 

Lupus anticoagulants are autoantibodies targeting negatively charged phospholipids or complexes of phospholipids.  They are noted in a variety of clinical conditions, including autoimmune diseases.  They are considered a risk factor for thrombosis.  This test may also be useful to evaluate recurrent fetal loss. 

 

Panel Information

This test is part of Panel: 

  • Antiphospholipid Antibody Syndrome Panel [LAB1230572] 
  • Thrombophilia Panel

Ordering Instructions

Please refrain from ordering Lupus Screens (LAB478) when patients are actively taking non vitamin K antagonists, including apixaban, argatroban, dabigatran, and rivaroxaban. They have a significant impact on clot-based coagulation testing.  It is best to carry these tests out prior to drug administration or during a trough setting.

Icons & Photos

x 4-6 (4 x 2.7 mL tubes or 6 x 1.8 mL tubes)

Collection Instructions

Specimen Collection: Blood

 

Container(s): (4 - 6) x 3.2% Na Citrate Tube (blue top)

Preferred Volume to Collect: 10.8 mL

Minimum Volume to Collect: 8.1 mL

Capillary collect ok: No

Microtainer acceptable: No

 

Collection Instructions:

  • Detailed instructions (link): Anticoagulant Correction for High Hematocrit
  • Detailed instructions (link): Blue Citrate Tube

  • Please be sure to collect the correct amount of blood. 4 x 2.7 mL tubes, 6 x 1.8 mL tubes. 6 labels may print. Place any extra labels with the patient's specimen.

  • Specimen should be processed within 1 hour – See Processing Instructions below.

 

Processing Instructions (Laboratory, Outpatient or Off-site collection)

  • Processed Specimen: Platelet Poor Plasma
  • Centrifuge/Spin: Yes
  • Aliquot: Yes
  • Processing Instructions:
    • Detailed instructions (link): Preparing Platelet Poor Plasma
    • Separate plasma into 4 - 6 aliquots, minimum of 0.5 mL each.
    • Freeze aliquots in plastic transport tubes immediately.
  • Transport Temperature:
    • Ambient (up to 1 hour in whole blood state)
    • Frozen (plasma only >1 hour)

Rejection Criteria

  • Hemolysis
  • Specimen has been thawed

Specimen Stability

Ambient: 4 hours

Frozen: 2 months – Platelet poor plasma; aliquoted and frozen within 1 hour of collection

Retention Time: 2 months

Reflex Information

Link: Mandatory reflex approved by MEC

 

Pathologist interpretation reported with test results if indicated.

 

Reflex testing may include the following: PT, aPTT, aPTT heparin neutralization, unfractionated heparin level, lupus confirmation, LA1 mix, LA2 mix, PT mix study, and aPTT mix study.

Test Frequency

Monday-Friday, usual TAT 1-4 days.

Reference Range

LA1: ≤43 seconds

LA2: ≤35 seconds

Ratio LA1/LA2: ≤1.30

Performing Department

COAGULATION

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

Simplified Dilute Russell Viper Venom test

CPT

85613

CDM Code

4094134

Epic Test ID

1230100900

Beaker LOINC

LA 1 MIXING STUDY: 50008-2
LA1/LA2 RATIO: 50410-0
LA2 MIXING STUDY: 50008-2
LUPUS ANTICOAGULANT 1: 53748-0
LUPUS ANTICOAGULANT 2: 57838-5

Mayo Access Code

SHO4134

Reviewed Date

10/11/2021

Beaker Names

Beaker Procedure Name: LUPUS ANTICOAGULANT
Beaker Display Name: Lupus Screen DRVVT
BEAKER TEST NAME: LUPUS SCREEN
BEAKER TEST REPORT NAME: Lupus Anticoagulant Screen

Beaker Synonyms

LUPUS SCREEN

Beaker Collection and Specimen Handling

BEAKER COLLECTION: +(1)S10/PO/F

Beaker Location, Container and Temperature

BW COAGULATION: BLUE TOP TUBE