Alberta Precision Laboratories

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Organization:

Alberta Precision Laboratories

Test Name/Synonym:

Antiphospholipid Syndrome Investigation
(Synonym: Anti-Beta-2 Glycoprotein, Anti-Cardiolipin Antibody, Anticardiolipin, APA, APLS, APS, Cardiolipin, DRVVT, Dilute Russell Viper Venom Time, Lupus Anticoagulant)

Clinical Indications:

Presence of antiphospholipid antibodies aid in the diagnosis of antiphospholipid syndrome (APS) in association with other lab tests and specific clinical manifestations.

Test Includes:

Anti-Beta-2 Glycoprotein IgG isotype
Anti-Cardiolipin Antibody IgG isotype
Lupus Anticoagulant.

Collection Alert:

Anti-Beta-2 Glycoprotein and Anti-Cardiolipin can be collected at any site.

All Hospitals (Inpatients and Outpatient collection labs) can collect. For community Patient Service Centres (PSC), Lupus Anticoagulant testing can ONLY be collected at the PSCs listed below.

Shipping and Handling Alert:

Specimens are time sensitive.

LABID (Connect Care):

LAB478

Specimen Type:

Blood

Primary Container:

LT BLUE CITRATE and GOLD SST

Alternate Containers:

For Lupus Anticoagulant:
No alternate container type

For Anti-Beta-2 Glycoprotein and Anti-Cardiolipin:
RED
Microcollection: MICRO SST

Minimum Collection Volume:

For testing sent to Calgary:
Three 2.7 mL LT BLUE CITRATE tubes, allow the vacuum tube to completely fill, minimum fill is to frosted line on tube and one GOLD SST minimum 1.0 mL.

For testing sent to Edmonton:
Two 2.7mL LT BLUE CITRATE tubes, allow the vacuum tube to completely fill, minimum fill is to frosted line on tube and one GOLD SST minimum 1.0 mL.

For pediatric and neonate testing contact Special Coagulation Laboratory. If unable to contact, draw volume according to weight restriction guidelines.

Specimen Collection Requirements:

Lt Blue Citrate: It is important to fill tube to maximum draw.
Mix well immediately after collection by inverting tube 3 to 4 times.
If venous access is not available, sample can be drawn from a line but 6x the volume of the line or 5 mL (whichever is less) must be removed prior to collection.

When using a winged blood collection set (butterfly needle), a discard tube must be used to remove the air in the tubing, if only a citrate tube is drawn or is the first tube drawn.

All Hospitals (Inpatients and Outpatient collection labs) can collect. For community Patient Service Centres (PSC), Lupus Anticoagulant testing can ONLY be collected at the following PSCs:
Edmonton Zone:	Meadowlark Patient Service Centre Northgate Patient Service Centre Heritage Patient Service Centre Tawa Patient Service Centre Windermere Patient Service Centre Leduc Patient Service Centre Athabasca Place (Sherwood Park) Patient Service Centre
Central Zone:	Camrose Patient Service Centre Red Deer Downtown Patient Service Centre Red Deer Bower Plaza Patient Service Centre Lloydminster Patient Service Centre
North Zone:	Franklin (Fort McMurray) Patient Service Centre Grande Prairie Patient Service Centre
Calgary Zone:	All Calgary Zone Patient Service Centres
South Zone:	Medicine Hat Patient Service Centre Lethbridge Centre Village Patient Service Centre Lethbridge Highlands Patient Service Centre Brooks Patient Service Centre
Mobile	Test cannot be collected by Mobile Collection Service (MCS)

Test Resources:

Antiphospholipid Syndrome Investigation Requisition

Stability and Storage:

LT BLUE CITRATE: Room temperature – 3.5 hours
GOLD SST: Refrigerated temperature - 5 days

Processing:

For GOLD SST:

For testing sent to Calgary:	For testing sent to Edmonton:
Centrifuge Do not aliquot.	Centrifuge and aliquot serum into polypropylene or polystyrene tube and freeze.

For LT BLUE CITRATE:

For testing sent to Calgary:	For testing sent to Edmonton:
For specimens that will be received at performing location within 3.5 hours from collection, transport uncentrifuged at room temperature. For specimens that will be received beyond stability: Centrifuge to obtain platelet poor plasma (platelet count <10 x 10⁹/L) Aliquot plasma as per Special Coagulation Aliquoting sent to Calgary PX06-01.600	Centrifuge to obtain platelet poor plasma (platelet count <10 x 10⁹/L) Aliquot as per Special Coagulation Aliquoting sent to Edmonton PX06-01.610

Platelet poor plasma must be prepared in accordance with the College of Physician and Surgeons of Alberta (CPSA) Laboratory Standard H.4.3.4. This must include procedures for regular verification that centrifuge(s) reliably produce plasma containing <10 x 10⁹/L residual platelets. Please contact Special Coagulation in Calgary 403-770-3598 (ext 3) or in Edmonton 780-407-8487 for detailed instructions.

Transportation:

For testing sent to Calgary:

GOLD SST: Transport at refrigerated temperature
LT BLUE CITRATE: See instructions in processing section.

For testing sent to Edmonton:

Transport frozen.(dry ice if available) - Specimens must maintain frozen state for entire duration of transport.

Method:

Anti-CL and Anti-β2GP1 – Multiplex bead immunoassay (Bioplex)

Method and Interpretation of Results:

Positive lupus anticoagulant and/or moderate to strong titers of anti-cardiolipin IgG and/or anti-beta-2glycoprotein1 IgG antibodies in association with specific clinical manifestations may be diagnostic for Antiphospholipid Syndrome.

Routine Turn Around Time:

Lupus anticoagulant: Within 2 weeks of receipt of sample.
Anti-Cardiolipin Antibody and Anti-Beta-2 Glycoprotein: 1 - 3 days

Testing Schedule:

Lupus Anticoagulant performed in Special Coagulation - Batched
Anti-Beta-2 Glycoprotein and Anti-Cardiolipin Antibody performed in Biochemistry – Monday to Friday

For stat testing in Calgary: Contact Special Coagulation Laboratory. After hours contact the Hematopathologist on call.

For stat testing in Edmonton: MUST contact the Hematopathologist or Clinical Biochemist on call.

Reference Interval:

Lupus Anticoagulant: See Laboratory Report.

Anti-Beta-2 Glycoprotein:

Negative: Less than 20.0 U/mL
Low Positive: 20.0 - 40.0 U/mL
Moderate Positive: 40.1 - 80.0 U/mL
High Positive: Greater than 80.0 U/mL

Anti-Cardiolipin Antibody:

Negative: Less than 20.0 GPL - U/mL
Low Positive: 20.0 - 40.0 GPL - U/mL
Moderate Positive: 40.1 - 80.0 GPL - U/mL
High Positive: Greater than 80.0 GPL - U/mL

Testing Area:

Biochemistry and Special Coagulation

Performing Site:

Calgary	Diagnostic and Scientific Centre
Edmonton	University of Alberta Hospital

Contact Comments:

1-877-868-6848

Last Updated On:

Tuesday, March 18, 2025