Ordering Recommendation

Assist in distinguishing between inherited and acquired forms of thrombotic thrombocytopenic purpura (TTP).  Recommended initial test for the identification of autoantibodies to ADAMTS13, since the ADAMS13 inhibitor test is more specific for acquired TTP than the ADAMTS13 antibody test.  If suspicion for TTP remains after a negative result, ADAMTS13 Antibody (3000182) is recommended.

Mnemonic
ADAMTS IN
Methodology

Quantitative Enzyme-Linked Immunosorbent Assay

Performed

Sun-Sat

Reported

1-3 days

New York DOH Approval Status
Specimens from New York clients will be sent out to a New York DOH approved laboratory, if possible.
Specimen Required
Patient Preparation
Collect

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

Specimen Preparation

Transfer 1 mL platelet-poor plasma to an ARUP Standard Transport Tube. (Min: 1 mL)

Storage/Transport Temperature

CRITICAL FROZEN. Separate specimens must be submitted when multiple tests are ordered.

Unacceptable Conditions

Serum or EDTA plasma. Clotted or hemolyzed specimens.

Remarks
Stability

Ambient: 2 hours; Refrigerated: Unacceptable; Frozen: 2 weeks (No freeze/thaw cycles.)

Reference Interval

0.4 BU (Bethesda Units) or less

Interpretive Data

The majority of cases of idiopathic thrombotic thrombocytopenic purpura (TTP) are caused by ADAMTS13 autoantibodies. Autoantibodies that neutralize ADAMTS13 function are found in approximately two-thirds of idiopathic cases and can be identified and titered by the ADAMTS13 inhibitor test. Non-neutralizing autoantibodies that result in increased ADAMTS13 clearance, but do not inhibit function, are found in approximately one-third of idiopathic TTP cases. Non-neutralizing antibodies are not detected in the inhibitor test but can be detected by ELISA (ADAMTS13 antibody test). ADAMTS13 autoantibodies are not present in congenital TTP (Upshaw-Schulman syndrome). Correlation with clinical information, ADAMTS13 activity, and other relevant laboratory testing is suggested.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

85335

Components
Component Test Code* Component Chart Name LOINC
3000229 ADAMTS13 Inhibitor 40824-5
* 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
  • von Willebrand Factor Cleaving Protease Inhibitor
ADAMTS13 Inhibitor