Test Code ADAMP ADAMTS13 Activity with Reflex Inhibitor Profile, Plasma
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
620815Useful 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.
Special Instructions
Method Name
ADAMS, ADMB: Fluorescence Resonance Energy Transfer (FRET)
ADMI, AADAM: Technical Interpretation
Specimen Type
Plasma Na CitSpecimen 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
Interpretation
Less than 10% ADAMTS13 activity is highly indicative of thrombotic thrombocytopenic purpura (TTP) in an appropriate clinical setting. The presence of ADAMTS13 measurable Bethesda titer is most consistent with an acquired (autoimmune) TTP.
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 daysSpecimen Retention Time
7 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterCPT 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 |