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Test ID ADIC Disseminated Intravascular Coagulation/Intravascular Coagulation and Fibrinolysis (DIC/ICF) Profile, Plasma


Ordering Guidance


This profile will not detect all bleeding disorders such as von Willebrand disease. For patients with amyloidosis and bleeding symptoms, obtaining a limited bleeding diathesis profile is suggested.

 

Multiple coagulation profile tests are available. See Coagulation Profile Comparison in Special Instructions for testing that is performed with each profile.



Shipping Instructions


Send the 5 aliquot tubes in the same shipping container.



Necessary Information


If priority specimen, mark request form, give reason, and request a call-back.



Specimen Required


Patient Preparation: Patient should not be receiving Coumadin or heparin. If so, note on request.

Specimen Type: Platelet-poor plasma

Collection Container/Tube: Light-blue top (3.2% sodium citrate)

Submission Container/Tube: 5 Plastic vials

Specimen Volume: 5 mL in 5 plastic vials, each containing 1 mL

Collection Instructions:

1. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing in Special Instructions.

2. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.

3. Aliquot plasma (1 mL per aliquot) into 5 separate 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.

Additional Information: Double-centrifuged specimen is critical for accurate results as platelet contamination may cause spurious results.


Forms

1. Coagulation Patient Information (T675) in Special Instructions.

2. If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.

Useful For

Establishing laboratory evidence of disseminated intravascular coagulation

Profile Information

Test ID Reporting Name Available Separately Always Performed
ADICI DIC/ICF Prof Interpretation No Yes
APTSC Activated Partial Thrombopl Time, P Yes, (order APTTP) Yes
TTSC Thrombin Time (Bovine), P Yes Yes
CLFIB Fibrinogen, Clauss, P Yes, (order FIBTP) Yes
DIMER D-Dimer, P Yes, (order DDITT) Yes
PTSC Prothrombin Time (PT), P Yes, (order PTTP) Yes

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
RTSC Reptilase Time, P Yes No
DRV1 Dilute Russells Viper Venom Time, P Yes, (order DRVI1) No
PNP Platelet Neutralization Procedure No No
PTMSC PT Mix 1:1 No No
APMSC APTT Mix 1:1 No No
DRV2 DRVVT Mix No No
DRV3 DRVVT Confirmation No No
F_2 Coag Factor II Assay, P Yes No
FACTV Coag Factor V Assay, P Yes No
F_7 Coag Factor VII Assay, P Yes No
F8A Coag Factor VIII Activity Assay, P Yes No
F_9 Coag Factor IX Assay, P No No
F_10 Coag Factor X Assay, P Yes No
F_11 Coag Factor XI Assay, P Yes No
F_12 Coag Factor XII Assay, P Yes No
STACL Staclot LA, P No No
PTFIB PT-Fibrinogen, P Yes No
SOLFM Soluble Fibrin Monomer No No

Testing Algorithm

Initial testing includes prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen, D-dimer, and disseminated intravascular coagulation/intravascular coagulation and fibrinolysis (DIC/ICF) profile interpretation.

If PT is >13.9 seconds, then PT mix will be performed at an additional charge.

If aPTT is ≥38 seconds, then aPTT mix and dilute Russell viper venom time (dRVVT) will be performed at an additional charge.

If dRVVT ratio is ≥1.20, then dRVVT mix and dRVVT confirmation will be performed at an additional charge.

If fibrinogen is <150 mg/dL, or clinically indicated, then PT-fibrinogen will be performed at an additional charge.

If D-dimer is >500 ng/mL fibrinogen equivalent units (FEU), then soluble fibrin monomer will be performed at an additional charge.

If aPTT mix is ≥38 seconds and TT is <35.0 seconds (no evidence of heparin), then platelet neutralization procedure will be performed at an additional charge.

If TT is ≥25.0 seconds, then reptilase time will be performed at an additional charge.

Method Name

PTSC, APTSC, TTSC: Optical Clot-Based

CLFIB: Clauss

DIMER: Latex Immunoassay (LIA)

Reporting Name

DIC/ICF Prof

Specimen Type

Plasma Na Cit

Specimen Minimum Volume

5 mL in 5 plastic vials, each containing 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Plasma Na Cit Frozen 14 days

Clinical Information

Disseminated intravascular coagulation (DIC) and intravascular coagulation and fibrinolysis (ICF), collectively termed DIC/ICF is a consumptive hemorrhagic and microthrombotic disorder that manifests as clinical bleeding or thrombosis. Conditions associated with DIC/ICF can include sepsis, trauma (eg, head injury, severe tissue injury), obstetric complications (eg, amniotic fluid embolism, abruptio placentae), malignancies, vascular disorders (eg, hemangiomas, aortic aneurysm), and immunologic disorders.

 

These disorders can cause formation of thrombin and fibrin intravascularly, which can result in widespread fibrin deposition contributing to thrombosis and organ failure or, conversely, can result in bleeding due to consumption of coagulation proteins and platelets. DIC/ICF is not a disease, rather it is a syndrome that is secondary to an underlying disorder.

Reference Values

An interpretive report is provided.

Interpretation

An interpretive report will be provided.

Clinical Reference

Boender J, Kruip MJ, Leebeek FWG: A diagnostic approach to mild bleeding disorders. J Thromb Haemost. 2016 Aug;14(8):1507-1516. doi: 10.1111/jth.13368

Day(s) Performed

Monday through Friday

Report Available

1 to 7 days

Test Classification

See Individual Test IDs

CPT Code Information

85610-PTSC 85730-APTSC 85670-TTSC 85379-DIMER 85384-CLFIB 85390-26-ADICI

85210-Factor II (if appropriate)

85220-Factor V (if appropriate)

85230-Factor VII (if appropriate)

85240-Coagulation factor VIII assay (if appropriate)

85250-Factor IX (if appropriate)

85260-Factor X (if appropriate)

85270-Factor XI (if appropriate)

85280-Factor XII (if appropriate)

85366-Soluble fibrin monomer (if appropriate)

85385-PT-Fibrinogen (if appropriate)

85597-Platelet neutralization for lupus inhibitor (if appropriate)

85598-Staclot LA (if appropriate)

85611-PT mix 1:1 (if appropriate)

85613-DRVVT (if appropriate)

85613-DRVVT mix (if appropriate)

85613-DRVVT confirm (if appropriate)

85635-Reptilase time (if appropriate)

85732-APTT mix 1:1 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ADIC DIC/ICF Prof 98125-8

 

Result ID Test Result Name Result LOINC Value
CLFIB Fibrinogen, Clauss, P 48664-7
TTSC Thrombin Time (Bovine), P 46717-5
603323 Reviewed by 18771-6
DIMER D-Dimer, P 48067-3
APTSC Activated Partial Thrombopl Time, P 14979-9
PTSEC Prothrombin Time (PT), P 5902-2
INRSC INR 6301-6
603182 DIC/ICF Prof Interpretation 69049-5