Alpha-2 Plasmin Inhibitor, Plasma

CPT CODE:

USEFUL FOR:

Diagnosing congenital alpha-2 plasmin inhibitor deficiencies (rare)
Providing a more complete assessment of disseminated intravascularcoagulation, intravascular coagulation and fibrinolysis, or hyperfibrinolysis (primary fibrinolysis), when measured in conjunction with fibrinogen, fibrin D-dimer, fibrin degradation products, soluble fibrin monomer complex, and plasminogen
Evaluating liver disease or the effects of fibrinolytic or antifibrinolytic therapy

SPECIMEN REQUIRED:

See "Coagulation Studies" in Special Instructions.
1. Draw blood in a light blue-top (citrate) tube(s). Spin down, remove     plasma, spin plasma again, and place 1 mL of platelet-poor plasma      in plastic vial. (Glass vial is not acceptable.)    Note:   Double-centrifuged specimens are critical for accurate                     results as platelet contamination may cause spurious                     results.2. Freeze specimen immediately at < or = -40 degrees C if possible.3. Send specimen frozen.Note:      1.  Each coagulation assay requested should have its                        own vial.                  2. If ordering electronically, no form is required with the specimen.                        If not ordering electronically, please complete and submit a                        "Coagulation Request Form" (Supply T237) with the specimen.

TRANSPORT TEMPERATURE:

Frozen\Refrig NO\Ambient NO

CLINICAL INFORMATION:

Alpha-2 plasmin inhibitor (antiplasmin) is synthesized in the liver with a biological half-life of approximately 3 days. It inactivates plasmin, the primary fibrinolytic enzyme responsible for remodeling the fibrin thrombus, and binds fibrin, together with factor XIIIa, making the clot more difficult to lyse. Absence of alpha-2 plasmin inhibitor results in uncontrolled plasmin-mediated breakdown of the fibrin clot and is associated with increased risk of bleeding.

CLINICAL INTERPRETATION:

Patients with congenital homozygous deficiency (with levels of <10%)are clinically affected (bleeding). Heterozygotes having levels of 30% to 60% of mean normal activity, are usually asymptomatic.
Lower than normal levels may be suggestive of consumption due toactivation of plasminogen and its inhibition by alpha-2 plasmin inhibitor.
The clinical significance of high levels of alpha-2 plasmin inhibitor is unknown.

REFERENCE VALUES:

Adults:  80-140%

Normal, full-term newborn infants may have borderline low or mildly

decreased levels (> or =50%) which reach adult levels within 5-7 days

postnatal. Healthy, premature infants (30-36 weeks gestation) may have

mildly decreased levels which reach adult levels in < or =90 days

postnatal.*

*See "Pediatric Hemostasis References" in Coagulation Studies

in Special Instructions.