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23417 Comprehensive Antiphospholipid Syndrome

Comprehensive Antiphospholipid Syndrome
Test Code: CAPS
Synonyms/Keywords
CAPS, Anti-Phospholipid Antibodies, Anticardiolipin Antibodies, Antiphospholipid Antibodies, Cardiolipin, Cardiolipin Antibodies, Antiphospholipid syndrome, APS, anti-B2-GP1 antibodies, Beta 2 glycoprotein, Beta-2 glycoprotein, Beta-2 GP1, systemic lupus erythematosus, SLE
Test Components
Antiphospholipid Antibodies (APLSAB), Mixing Study (MIX), Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT), Comp Antiphospholipid Interpretation (CAPSINT)
Useful For

​Determine the presence of antiphospholipid antibodies that may be associated with an increased risk for arterial or venous thrombosis or obstetric complications.

Specimen Requirements

​Note: Serum and Platelet Poor Plasma required​​​​​​ ​ ​
​Specimen Type

 Preferred Container/Tube Acceptable Container/Tube Specimen Volume
​Serum
​Red Top Tube (RTT)
Serum Separator Tube (SST)​​​1.0 mL serum aliquot
​*Platelet Poor Plasma
  3.2% Citrated Blue Top Tube (BTT)​ ​ 3-4 1.5 mL aliquots of citrated plasma​ (see Collection Processing Instructions)
Collection Processing Instructions
Serum (RTT or SST):  Samples collected in a RTT must be removed from the clot within one hour for storage or transport. Samples collected in an SST must be processed and serum removed from the primary tube within 4 hours for storage or transport.
 
Citrated Plasma (BBT):  Collect in approximately 3-4 Citrated Blue Top Tubes (BTT), aliquot each.
- Citrate anticoagulant must be adjusted for HCT >55%.
- Tube must be at least 90% full.
- Invert completely 3-4 times (without shaking) to mix.
Specimen Stability Information
Specimen Type Temperature Time
​Serum Refrigerated ​2 days
​Frozen ​6 months
​Plasma ​ ​ ​Ambient
 4 hours
​Refrigerated
4 hours
Frozen
6 months
Rejection Criteria
Clotted or Hemolyzed
​Contamination with IV or Hickman Line fluid
​Specimens that thaw during storage or transport
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ MIX (PT, APTT): Monday - Friday​ Less than 2 hours​ Siemens Sysmex CS2500​
​ DRVVT: Monday, Wednesday, Friday Less than 2 hours​ Optical clot detection/ACL Top 550
​ SCT: Monday, Wednesday, Friday​ Less than 2 hours​ Optical clot detection/ACL Top 550
​ Factor Assays if needed:  Monday - Friday​ Less than 2 hours​ Siemens Sysmex CS2500 ​
​
​APLSAB:  Monday - Friday
​2 to 4 hours
​Multiplex Flow Immunoassay/Bio-Rad Bioplex 2200
Test Information
​Prothrombin Time, Activated Partial Thromboplastin Time, Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT) and Antiphospholipid Antibodies (APLSAB) will be performed. If the PT and/or APTT are prolonged mixing studies will be performed.  Reflex testing for factor assays will be performed based on the results of PT (INR) and/or APTT mixing studies and the basic coagulation scheme.  
 
Requested panel includes Lupus anticoagulant testing (DRVVT and SCT), these tests should not be performed on patients receiving rivaroxaban, apixaban, dabigatran, edoxaban, or warfarin.  For patients on these medications, order the Antiphospholipid Antibodies (APLSAB) individually instead of the panel.
Reference Range Information
Performing Location Reference Range
​Marshfield ​See individual test listings for reference ranges.
Interpretation

Prothrombin Time, Activated Partial Thromboplastin Time, Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT) and Antiphospholipid Antibodies (APLSAB) will be performed. If the PT and/or APTT are prolonged mixing studies will be performed.  Reflex testing for factor assays will be performed based on the results of PT (INR) and/or APTT mixing studies and the basic coagulation scheme. 

Requested panel includes Lupus anticoagulant testing (DRVVT and SCT), these tests should not be performed on patients receiving rivaroxaban, apixaban, dabigatran, edoxaban, or warfarin.  For patients on these medications, order the Antiphospholipid Antibodies (APLSAB) individually instead of the panel.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
85610​ ​ ​ Protime/INR ​ ​
85730​ ​ ​ APTT​ ​
85613​ ​ ​ DRVVT​ ​
85732​ ​ ​ SCT ​
​86146​​3​Antiphospholipid Antibodies (Beta 2 Glycoproteins IgA, IgM, IgM)​
​86147​​3​Antiphospholipid Antibodies (Cardiolipin Antibodies IgA, IgG, IgM)​
Varies​ ​ ​ Factor assays vary with follow-up​ ​
Synonyms/Keywords
CAPS, Anti-Phospholipid Antibodies, Anticardiolipin Antibodies, Antiphospholipid Antibodies, Cardiolipin, Cardiolipin Antibodies, Antiphospholipid syndrome, APS, anti-B2-GP1 antibodies, Beta 2 glycoprotein, Beta-2 glycoprotein, Beta-2 GP1, systemic lupus erythematosus, SLE
Test Components
Antiphospholipid Antibodies (APLSAB), Mixing Study (MIX), Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT), Comp Antiphospholipid Interpretation (CAPSINT)
Ordering Applications
Ordering Application Description
​Cerner CAPS Powerplan ​Capture.PNG​     
4medica
 ​Comprehensive Antiphospholipid Syndrome [CAPS]
​
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements

​Note: Serum and Platelet Poor Plasma required​​​​​​ ​ ​
​Specimen Type

 Preferred Container/Tube Acceptable Container/Tube Specimen Volume
​Serum
​Red Top Tube (RTT)
Serum Separator Tube (SST)​​​1.0 mL serum aliquot
​*Platelet Poor Plasma
  3.2% Citrated Blue Top Tube (BTT)​ ​ 3-4 1.5 mL aliquots of citrated plasma​ (see Collection Processing Instructions)
Collection Processing
Serum (RTT or SST):  Samples collected in a RTT must be removed from the clot within one hour for storage or transport. Samples collected in an SST must be processed and serum removed from the primary tube within 4 hours for storage or transport.
 
Citrated Plasma (BBT):  Collect in approximately 3-4 Citrated Blue Top Tubes (BTT), aliquot each.
- Citrate anticoagulant must be adjusted for HCT >55%.
- Tube must be at least 90% full.
- Invert completely 3-4 times (without shaking) to mix.
Specimen Stability Information
Specimen Type Temperature Time
​Serum Refrigerated ​2 days
​Frozen ​6 months
​Plasma ​ ​ ​Ambient
 4 hours
​Refrigerated
4 hours
Frozen
6 months
Rejection Criteria
Clotted or Hemolyzed
​Contamination with IV or Hickman Line fluid
​Specimens that thaw during storage or transport
Useful For

​Determine the presence of antiphospholipid antibodies that may be associated with an increased risk for arterial or venous thrombosis or obstetric complications.

Test Components
Antiphospholipid Antibodies (APLSAB), Mixing Study (MIX), Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT), Comp Antiphospholipid Interpretation (CAPSINT)
Reference Range Information
Performing Location Reference Range
​Marshfield ​See individual test listings for reference ranges.
Interpretation

Prothrombin Time, Activated Partial Thromboplastin Time, Dilute Russell Viper Venom Time (DRVVT), Silica Clotting Time (SCT) and Antiphospholipid Antibodies (APLSAB) will be performed. If the PT and/or APTT are prolonged mixing studies will be performed.  Reflex testing for factor assays will be performed based on the results of PT (INR) and/or APTT mixing studies and the basic coagulation scheme. 

Requested panel includes Lupus anticoagulant testing (DRVVT and SCT), these tests should not be performed on patients receiving rivaroxaban, apixaban, dabigatran, edoxaban, or warfarin.  For patients on these medications, order the Antiphospholipid Antibodies (APLSAB) individually instead of the panel.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Marshfield​ MIX (PT, APTT): Monday - Friday​ Less than 2 hours​ Siemens Sysmex CS2500​
​ DRVVT: Monday, Wednesday, Friday Less than 2 hours​ Optical clot detection/ACL Top 550
​ SCT: Monday, Wednesday, Friday​ Less than 2 hours​ Optical clot detection/ACL Top 550
​ Factor Assays if needed:  Monday - Friday​ Less than 2 hours​ Siemens Sysmex CS2500 ​
​
​APLSAB:  Monday - Friday
​2 to 4 hours
​Multiplex Flow Immunoassay/Bio-Rad Bioplex 2200
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
85610​ ​ ​ Protime/INR ​ ​
85730​ ​ ​ APTT​ ​
85613​ ​ ​ DRVVT​ ​
85732​ ​ ​ SCT ​
​86146​​3​Antiphospholipid Antibodies (Beta 2 Glycoproteins IgA, IgM, IgM)​
​86147​​3​Antiphospholipid Antibodies (Cardiolipin Antibodies IgA, IgG, IgM)​
Varies​ ​ ​ Factor assays vary with follow-up​ ​
For most current information refer to the Marshfield Laboratory online reference manual.