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HelpTest Code APCRR Activated Protein C Resistance V, with Reflex to Factor V Leiden, Blood and Plasma
Useful For
Evaluating patients with incident or recurrent venous thromboembolism (VTE)
Evaluating individuals with a family history of VTE
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| APCRV | Activated Protein Resistance V, P | Yes | Yes |
| SC018 | Whole Blood | No | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| F5DNA | Factor V Leiden (R506Q) Mutation, B | Yes | No |
| F5DNI | APCRV/F5DNA Summary Interpretation | No | No |
Testing Algorithm
If the assay ratio is abnormal, then factor V Leiden variant analysis will be performed at an additional charge.
When the activated protein C resistance V is abnormal or indeterminate and the factor V Leiden variant assay is performed, a summary interpretation will be provided.
Special Instructions
Method Name
Optical Clot-Based
Reporting Name
APCRV, w/Reflex, PSpecimen Type
Plasma Na CitWhole blood
Necessary Information
Specimen Required
Blood and plasma are required.
Patient Preparation: Fasting preferred
Specimen Type: Whole blood
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD) or light-blue top (3.2% sodium citrate)
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Specimen Type: Platelet-poor plasma
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Submission Container/Tube: Plastic vial, polypropylene preferred
Specimen Volume: 1 mL
Collection Instructions:
1. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.
2. Within 4 hours of collection, centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.
3. Aliquot plasma into separate plastic vial leaving 0.25 mL in the bottom of centrifuged vial.
4. Freeze plasma aliquot immediately at -20° C, or ideally, at -40° C or below.
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 Minimum Volume
Plasma: 0.5 mL; Whole blood: 3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma Na Cit | Frozen | 14 days | |
| Whole blood | Ambient (preferred) | 14 days | |
| Frozen | 14 days | ||
| Refrigerated | 14 days |
Reference Values
ACTIVATED PROTEIN C RESISTANCE V RATIO
≥2.3
Pediatric reference range has neither been established nor is available in scientific literature. The adult reference range likely would be applicable to children older than 6 months.
Interpretation
An activated protein C (APC) resistance ratio below 2.3 suggests abnormal resistance to APC of hereditary origin.
If the screening APC resistance test is abnormal, DNA-based testing for the factor V Leiden variant (p.Arg534Gln, formerly R506Q) is performed to confirm or exclude hereditary APC-resistance.
Clinical Reference
1. Nichols WL, Heit JA. Activated protein C resistance and thrombosis. Mayo Clin Proc. 1996;71(9):897-898
2. Dahlback B. Resistance to activated protein C as risk factor for thrombosis: molecular mechanisms, laboratory investigation, and clinical management. Semin Hematol. 1997;34(3):217-234
3. Rodeghiero F, Tosetto A. Activated protein C resistance and factor V Leiden mutation are independent risk factors for venous thromboembolism. Ann Intern Med. 1999;130(8):643-650. doi:10.7326/0003-4819-130-8-199904200-00004
4. Grody WW, Griffin JH, Taylor AK, Korf BR, Heit JA; ACMG Factor V. Leiden Working Group. American College of Medical Genetics consensus statement on factor V Leiden mutation testing [published correction appears in Genet Med. 2021 Dec;23(12):2463]. Genet Med. 2001;3(2):139-148. doi:10.1097/00125817-200103000-00009 5. Press RD, Bauer KA, Kujovich JL, Heit JA. Clinical utility of factor V Leiden (R506Q) testing for the diagnosis and management of thromboembolic disorders. Arch Pathol Lab Med. 2002;126(11):1304-1318. doi:10.5858/2002-126-1304-CUOFVL
6. Yohe S, Olson J: Thrombophilia: Assays and interpretation. In: Kottke-Marchant K, Davis B, eds. Laboratory Hematology Practice. Blackwell Publishing; 2012:492-508
Day(s) Performed
Monday through Friday
Report Available
4 to 7 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
85307
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| APCRR | APCRV, w/Reflex, P | 13590-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| APCR | APCRV Ratio | 13590-5 |
| SC018 | Whole Blood | No LOINC Needed |
| INT55 | Interpretation | 48591-2 |
Forms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing-Spanish (T826)
2. Coagulation Patient Information (T675)
3. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.