Test Code 8INHE Factor VIII Inhibitor Evaluation, Plasma
Ordering Guidance
This test is for factor VIII inhibitors only. If the patient is known to have hemophilia A, this is the correct test to order. If the presence or type of inhibitor is unknown, first order APROL / Prolonged Clot Time Profile, Plasma. When screening studies are needed for patients with known hemophilia B, order 9INHE / Factor IX Inhibitor Evaluation, Plasma.
Shipping Instructions
Send all vials in the same shipping container.
Necessary Information
Specimen Required
Specimen Type: Platelet-poor plasma
Patient Preparation:
1. Patient must not be receiving Coumadin (warfarin) or heparin therapy
2. Fasting preferred
Collection Container/Tube: Light-blue top (3.2% sodium citrate)
Submission Container/Tube: Plastic vials
Specimen Volume: 3 mL in 3 plastic vials, each containing 1 mL
Collection Instructions:
1. Specimen must be collected prior to factor replacement therapy.
2. For complete instructions, see Coagulation Guidelines for Specimen Handling and Processing.
3. Centrifuge, transfer all plasma into a plastic vial, and centrifuge plasma again.
4. Aliquot plasma (1-2 mL per aliquot) into 3 separate plastic vials, leaving 0.25 mL in the bottom of centrifuged vial.
5. Freeze plasma immediately (no longer than 4 hours after collection) at -20° C or, ideally, at -40° C or below.
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
Detecting the presence and titer of a specific factor inhibitor directed against coagulation factor VIII
This test is not useful for the detection of a lupus-like circulating anticoagulant inhibitor, a nonspecific circulating anticoagulant, or other inhibitors that are not specific for coagulation factors.
Disease States
- Hemophilia A
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
8INHT | FVIII Inhib Profile Tech Interp | No | Yes |
F8A | Coag Factor VIII Activity Assay, P | Yes | Yes |
Reflex Tests
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
8AINH | FVIII Inhib Profile Prof Interp | No | No |
8BETH | FVIII Bethesda Units, P | No | No |
F8IS | Coag Factor VIII Assay Inhib Scrn,P | No | No |
Special Instructions
Method Name
F8A, F8IS, 8BETH: Optical Clot-Based
8INHT: Technical Interpretation
8AINH: Medical Interpretation
Reporting Name
Factor VIII Inhib Profile, PSpecimen Type
Plasma Na CitSpecimen Minimum Volume
2 Plastic vials, each containing 1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma Na Cit | Frozen | 14 days |
Reject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | Reject |
Clinical Information
Factor VIII (FVIII) inhibitors are IgG antibodies directed against coagulation FVIII that typically result in development of potentially life-threatening hemorrhage. These antibodies may develop in 1 of 4 different patient populations:
-Patients with congenital FVIII deficiency (hemophilia A) in response to therapeutic infusions of factor VIII concentrate
-Older nonhemophiliac adult patients (not previously factor VIII deficient)
-Women in postpartum period
-Patients with other autoimmune illnesses
Reference Values
FACTOR VIII ACTIVITY ASSAY
Adults: 55-200%
Normal, full-term newborn infants or healthy premature infants typically have levels greater or equal to 40%.*
*See Pediatric Hemostasis References in Coagulation Guidelines for Specimen Handling and Processing.
FACTOR VIII INHIBITOR SCREEN:
Negative
GENERAL FACTOR BETHESDA UNITS:
≤0.5 Bethesda Units
Day(s) Performed
Monday through Friday
Report Available
1 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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 US Food and Drug Administration.CPT Code Information
85390-Factor VIII Tech Interp
85240-Factor VIII activity assay
85335-Bethesda titer (if appropriate)
85335-Factor VIII inhibitor screen (if appropriate)
85390-Factor VIII Professional Interp (if appropriate)
Forms
If not ordering electronically, complete, print, and send a Coagulation Test Request (T753) with the specimen.