Test ID A2PI Alpha-2 Plasmin Inhibitor, Plasma
Specimen Required
See Coagulation Guidelines for Specimen Handling and Processing in Special Instructions.
Specimen Type: Platelet-poor plasma
Collection Container/Tube: Light-blue top (citrate)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge, remove plasma, and centrifuge plasma again.
2. Freeze specimen immediately at ≤-40° C, if possible.
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.
Useful For
Diagnosing congenital alpha-2 plasmin inhibitor deficiencies (rare)
Providing a more complete assessment of disseminated intravascular coagulation, 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
Evaluating the effects of fibrinolytic or antifibrinolytic therapy
Special Instructions
Method Name
Chromogenic
Reporting Name
Alpha-2 Plasmin Inhibitor, PSpecimen Type
Plasma Na CitSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma Na Cit | Frozen | 14 days |
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.
Reference Values
Adults: 80-140%
Normal, full-term, and premature infants may have mildly decreased levels (≥50%) which reach adult levels ≤ 90 days postnatal.*
*See Pediatric Hemostasis References section in Coagulation Guidelines for Specimen Handling and Processing in Special Instructions.
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 to activation of plasminogen and its inhibition by alpha-2 plasmin inhibitor.
The clinical significance of high levels of alpha-2 plasmin inhibitor is unknown.
Clinical Reference
1. Lijnen HR, Collen D: Congenital and acquired deficiencies of components of the fibrinolytic system and their relation to bleeding or thrombosis. Blood Coagul Fibrinolysis 1989;3:67-77
2. Francis RB Jr: Clinical disorders of fibrinolysis: A critical review. Blut 1989;59:1-14
3. Aoki N: Hemostasis associated with abnormalities of fibrinolysis. Blood Rev 1989;3:11-17
Day(s) and Time(s) Performed
Monday through Friday; Varies
Analytic Time
3 daysTest Classification
This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
85410
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
A2PI | Alpha-2 Plasmin Inhibitor, P | 27810-1 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
A2PI | Alpha-2 Plasmin Inhibitor, P | 27810-1 |
Forms
If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.