Ordering Recommendation

Preferred initial panel when antiphospholipid syndrome (APS) is strongly suspected.

Mnemonic

PHOS SYN

Methodology

Electromagnetic Mechanical Clot Detection/Semi-Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Sun-Sat

Reported

1-2 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

Light Blue (Sodium Citrate) AND Serum Separator Tube (SST). Refer to Specimen Handling at aruplab.com for hemostasis/thrombosis specimen handling guidelines.

Specimen Preparation

Transport 2 mL platelet poor plasma in an ARUP Standard Transport Tube. (Min: 2 mL)
AND
Transport 1 mL serum in an ARUP Standard Transport Tube. (Min: 0.6 mL)

Storage/Transport Temperature

Plasma: CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.
Serum: Refrigerated.

Unacceptable Conditions

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

Remarks
Stability

Plasma: Ambient: 4 hours; Refrigerated: Unacceptable; Frozen at -20°C or below: 3 months; Frozen at -70°C or below: 18 months
Serum:
Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)

Reference Interval

Test Number
Components
Reference Interval
  B2Glycoprotein 1, IgG Antibody Effective November 15, 2021
<=20 SGU
  B2Glycoprotein 1, IgM Antibody Effective November 15, 2021
<=20 SMU
0050901 Cardiolipin Antibody, IgG Effective November 15, 2021
<=14 GPL Negative
15-19 GPL Indeterminate
20-80 GPL Low to Moderately Positive
81 GPL or above High Positive

0050902 Cardiolipin Antibody, IgM Effective November 15, 2021
<=12 MPL Negative
13-19 MPL Indeterminate
20-80 MPL Low to Moderately Positive
81 MPL or above High Positive

  PTT-LA Screen (PTT-D) 32-48 seconds
0030215 Prothrombin Time 12.0-15.5 seconds
  dRVVT Screen 33-44 seconds
  Thrombin Time 14.7-19.5 seconds
  Reptilase Time Less than 22.0 seconds
  PTT-D Heparin Neutralized 32-48 seconds
  PTT-D 1:1 Mix 32-48 seconds
  Platelet Neutralization (PTT-D, Confirm) Negative
  dRVVT 1:1 Mix 33-44 seconds
  dRVVT Confirmation Negative
  Hexagonal Phospholipid Neutral Reflex Negative

Interpretive Data

See individual components.

Compliance Category

FDA

Note

If PTT and dRVVT are normal, then 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 and PTT Heparin Neutralization are 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 apply.

Hotline History

N/A

CPT Codes

86147 x2; 86146 x2; 85610; 85730; 85613; if reflexed, additional CPT codes may apply: 85670; 85635; 85730; 85525; 85732; 85597; 85613 x2; 85598.

Components

Component Test Code* Component Chart Name LOINC
0030079 Lupus Anticoagulant Interpretation 75882-1
0030082 Hexagonal Phospholipid Neutral Reflex 33930-9
0030084 PTT-D Heparin Neutralized 52123-7
0030184 Platelet Neutralization (PTT-D, Confirm) 15191-0
0030189 dRVVT Confirmation 50410-0
0030232 PTT-LA Screen (PTT-D) 34571-0
0030246 Prothrombin Time 5902-2
0030270 Thrombin Time 3243-3
0030296 Reptilase Time 6683-7
0030323 PTT-D 1:1 Mix 5946-9
0030352 dRVVT Screen 6303-2
0030353 dRVVT 1:1 Mix 75513-2
0050322 B2Glycoprotein 1, IgG Antibody 44448-9
0050323 B2Glycoprotein 1, IgM Antibody 44449-7
0050901 Cardiolipin Antibody IgG 3181-5
0050902 Cardiolipin Antibody IgM 3182-3
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • ACA
  • aCL antibody
  • Anti-Phospholipid Syndrome Reflexive Panel (Antiphospholipid Syndrome Reflexive Panel)
  • APS panel
  • APS Reflexive Panel
  • B2Glycoprotein I
  • B2GPI
  • Cardiolipin Antibody
  • dRVVT Screen
  • Hexagonal Phospholipid Neutral Reflex
  • Hughes Syndrome Panel
  • Hypercoag
  • Hypercoagulable
  • Lupus Anticoagulant (LA)
  • Platelet Neutralization
  • Prothrombin Time
  • PTT-D Heparin Neutralized
  • Reptilase Time
  • Thrombin Time
Antiphospholipid Syndrome Reflexive Panel