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Test Code LAB1871 ADAMTS13 Activity with Reflex Inhibitor Profile, Plasma

Additional Codes

SQ: ADAMPM

MAYO: ADAMP


Ordering Guidance


Order the profile when considering a diagnosis of immune thrombotic thrombocytopenic purpura (iTTP), also known as acquired thrombotic thrombocytopenic purpura (aTTP). This diagnosis should be considered in a patient presenting with hemolytic anemia and thrombocytopenia. In patients with known iTTP/aTTP, the profile (rather than the single order ADAMTS13 activity) should be ordered if wanting to monitor presence of ADAMTS13 inhibitor.



Shipping Instructions


Send both vials in the same shipping container.



Specimen Required


Patient Preparation: Fasting preferred

Collection Container/Tube: Light-blue top (3.2% sodium citrate)

Submission Container/Tube: Plastic vials

Specimen Volume: 2 mL in 2 plastic vials each containing 1 mL

Collection Instructions:

1. Specimen must be collected prior to replacement therapy.

2. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing

3. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.

4. Aliquot plasma (1 mL per aliquot) into 2 separate plastic vials, leaving 0.25 mL in the bottom of centrifuged vial.

5. Freeze plasma immediately (no longer than 4 hours after collection) at -20° C or, ideally, below -40° C.

Additional Information:

1. Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.

2. Each coagulation assay requested should have its own vial.

Specimen Stability Information: Frozen 2 years


Forms

1. If not ordering electronically, complete, print, and send one of the following with the specimen:

-Renal Diagnostics Test Request (T830)

-Coagulation Test Request (T753)

2. Coagulation Patient Information (T675)

Secondary ID

620815

Useful For

Assisting with the diagnosis of immune or acquired thrombotic thrombocytopenic purpura

Profile Information

Test ID Reporting Name Available Separately Always Performed
ADAMS ADAMTS13 Activity Assay, P Yes Yes
ADMI ADAMTS13 Interpretation No Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
ADMB ADAMTS13 Inhibitor Titer, P No No
AADAM ADAMTS13 Profile Interpretation No No

Testing Algorithm

Testing begins with the ADAMTS13 activity assay to evaluate the percent activity. If the ADAMTS13 activity is less than 30%, the inhibitor titer and ADAMTS13 profile interpretation will be performed.

Method Name

ADAMS, ADMB: Fluorescence Resonance Energy Transfer (FRET)

ADMI, AADAM: Technical Interpretation

Reporting Name

ADAMTS13 Act w/Inhibitor Prof, P

Specimen Type

Plasma Na Cit

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Na Cit Frozen

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Reference Values

ADAMTS13 Activity Assay

≥70% 

Although not verified, the pediatric (<1 years old) reference range could be similar to or lower than that of adults.

 

ADAMTS13 Inhibitor Titer

<0.5 BU

Method Description

The ADAMTS13 activity is measured by a fluorescence resonance energy transfer-based assay using a synthetic fragment of von Willebrand factor as substrate. Cleavage of this small fragment by the ADAMTS13 protease generates fluorescence that is directly proportionate to the quantification of ADAMTS13 activity. (Package insert: ATS-13 ADAMTS13 Activity Assay 2.0. Immucor; 08/2023)

Day(s) Performed

Monday through Friday, Sunday

Report Available

1 to 3 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

85397

85335 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ADAMP ADAMTS13 Act w/Inhibitor Prof, P 53622-7

 

Result ID Test Result Name Result LOINC Value
621149 ADAMTS13 Interpretation 69049-5
620816 ADAMTS13 Activity 53622-7
620819 Interpretation 69049-5
621150 ADAMTS13 Interpretation No LOINC Needed