Test Code LAB5503 Protein S Antigen, Plasma
Performing Laboratory
Mayo Clinic Laboratories in RochesterReporting Name
Protein S Ag, PSpecimen Type
Plasma Na CitSpecimen Required
Specimen Type: Platelet-poor plasma
Patient Preparation: Patient must not be receiving heparin or Coumadin. If the patient is being treated with Coumadin, this should be noted. Coumadin will lower protein S.
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Submission Container/Tube: Plastic vials
Specimen Volume: 1 mL 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. Freeze plasma immediately (no longer than 4 hours after collection) at -20° C or, ideally  -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 | Special Container |
---|---|---|---|
Plasma Na Cit | Frozen | 14 days |
Specimen Minimum Volume
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 newborn 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 this test result 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.