Test Code LAB492 Protein S Antigen (Free)
Useful For
Useful for detecting deficiencies significant in the diagnosis of thrombosis. Protein S acts as a necessary cofactor to activated protein C, playing a part in the plasma anticoagulant system.
Decreased levels of protein S antigen can be seen in:
- Congenital defects (Type I, III)
- Vitamin K deficiency
- Inflammatory syndrome
- Hepatic disorders
- Nephrotic syndrome
- Oral contraceptives, anticoagulants, L-asparaginase
Elevated protein S levels are of uncertain clinical significance.
Methodology
Immunoturbidimetric
Performing Laboratory
Bozeman Health Laboratory Services
Specimen Requirements
Specimen must arrive and be tested within 4 hours of draw.
Specimen Type: Whole blood
Container/Tube: Blue top (3.2% sodium citrate)
Specimen Volume: Full tube
Collection Instructions: Click here to link to a You Tube video tutorial
1. Immediately after draw, invert tubes several times to mix blood with additive.
2. Send specimen in original tube.
3. If there is a delay in transport of >4 hours, specimen must be double-centrifuged to prepare a platelet-free plasma specimen as follows:
a. Immediately centrifuge at 3,200 rpm for 15 minutes.
b. Carefully remove plasma from cells avoiding platelet/buffy coat, and transfer plasma into a plastic tube.
c. Centrifuge plastic tube at 3,200 rpm for 15 minutes.
d. Carefully remove top portion of plasma and transfer plasma into a plastic tube leaving approximately 250 mL in bottom to discard.
e. Double-centrifuged plasma should be aliquoted (0.5 mL-1 mL each) into clearly labeled plastic tubes. (Glass vial is not acceptable.)
Note: Number of tests ordered will determine number of aliquots needed, generally 1 aliquot per test.
f. Specimens should be frozen at <-40° C, if possible, and sent together in same container with at least 5 lbs of dry ice. Specimens must arrive in a frozen state.
Additional Information: Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.
Specimen Transport Temperature
Ambient (whole blood) <4 hours/Frozen (plasma) >4 hours
Specimen Stability
Specmen Type | Temperature | Time |
---|---|---|
Whole Blood (unspun) | Ambient | 4 hours |
Plasma Na Citrate (spun) | Ambient | 4 hours |
Plasma Na Citrate (double spun) | Frozen | 14 days |
Reference Values
Males: 70-148%
Females: 50-134%
Additional Information
- During pregnancy,there is a decrease in free protein S level.
- Direct acting oral anticoagulants (eg, direct thrombin inhibitors: DTI, such as dabigatran [Pradaxa], argatroban [Acova], bivalirudin [Angiomax]) and direct factor Xa inhibitors (eg, rivaroxaban [Xarelto], apixaban [Eliquis], edoxaban [Savaysa]) may cause the protein S activity to appear spuriously normal (or elevated), when protein S activity is truly decreased (or normal). Clinical correlation is suggested, and in the absence of anticoagulation therapy, consider repeating the protein S activity and antigen assay.
- Coumadin therapy may result in decreased protein S activity and free protein S antigen.
Day(s) Test Set Up
Thursday
Test Classification and CPT Coding
85306-Protein S Ag, Free