Test Code LAB5503 Protein S Antigen, Plasma
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Reporting Name
Protein S Ag, PSpecimen Type
Plasma Na CitSpecimen Required
Specimen Type: Platelet-poor plasma
Patient Preparation:
1. Patient should not be receiving anticoagulant treatment (eg, warfarin, heparin). Warfarin will lower protein S. If not possible for medical reasons, note on request.
a. If medically feasible, for 4 to 6 hours before specimen collection, do not administer intravenous heparin.
b. If medically feasible, for 10 to 14 days before specimen collection, do not administer subcutaneous heparin or warfarin.
2. Patient should not be receiving fibrinolytic agents (streptokinase, urokinase, tissue plasminogen activator [tPA]).
3. It is recommended that specimens be collected pretransfusion. If patient has been transfused, a specimen should not be collected for 48 hours.
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Submission Container/Tube: Plastic vials (Polypropylene preferred)
Specimen Volume: 1 mL Platelet-poor plasma in 2 plastic vials, each containing 0.5 mL
Collection Instructions:
1. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.
2. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.
3. Aliquot 0.5 mL of plasma into 2 plastic vials, leaving 0.25 mL in the bottom of centrifuged vial.
4. Immediately freeze plasma (no longer than 4 hours after collection) at -20° C or, ideally at -40° C or below.
5. Send specimens in the same shipping container.
Additional Information: A double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma Na Cit | Frozen | 14 days |
Specimen Minimum Volume
Platelet-poor plasma: 0.5 mL
Special Instructions
Day(s) Performed
Monday through Friday
Specimen Retention Time
7 daysReport Available
1 to 3 daysReference Values
TOTAL
Males: 80-160%
Females:
<50 years: 70-160%
≥50 years: 80-160%
FREE
Males: 65-160%
Females:
<50 years: 50-160%
≥50 years: 65-160%
Normal, full-term infants or healthy premature infants may have decreased levels of total protein S (15-50%); but because of low levels of C4b-binding protein, free protein S may be normal or near the normal adult level (≥50%). Total protein S reaches adult levels by 90 to 180 days postnatal.*
*See Pediatric Hemostasis References section in Coagulation Guidelines for Specimen Handling and Processing
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PST | Protein S Ag, Total, P | No | No |
Useful For
Investigation of patients with a history of thrombosis
Testing Algorithm
If free protein S antigen is decreased, then total plasma protein S antigen will be performed at an additional charge.
CPT Code Information
85306-Free
85305-Total (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PSTF | Protein S Ag, P | 87557-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| PSF | Protein S Ag, Free, P | 27821-8 |
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PSF | Protein S Ag, Free, P | No | Yes |
Supportive Data
A retrospective review of Mayo Special Coagulation Laboratory data found that of 584 patients tested sequentially, only 4 patients demonstrated a pattern of normal free protein S antigen with decreased total protein S antigen. Three of these patients were receiving oral anticoagulant therapy and 1 had liver disease. There were 8 patients with probable congenital protein S deficiency. Of this group, all had significantly reduced levels of free protein S antigen and normal or mildly reduced levels of total protein S antigen. We conclude that omission of routine measurement of total protein S antigen and substituting measurement of free protein S antigen with reflexive testing of total protein S antigen only for decreased free protein S antigen would not decrease clinical sensitivity of this assay system for detecting hereditary protein S deficiency.
Forms
If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.