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Test ID: Factor XIII
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Factor XIII Assay
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Useful For
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To detect deficiency of Factor XIII. Monitoring of substitution therapy with Factor XIII concentrate
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Method name and description
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Chromogenic.
Test is performed using Sysmex CS5100 analyzer. FXIII in the sample is converted by the action of thrombin in to FXIIIa. Fibrin formed by thrombin also accelerates this reaction. Fibrin produced by the action of thrombin is prevented from forming clots by an aggregation inhibiting Peptide and held in solution.
FXIIIa cross-links a specific peptide substrate to glycine ethyl ester, thereby releasing ammonia. The ammonia released is then determined in a parallel enzymatic reaction.
The decrease in NADH is measured by monitoring the absorbance at 340 nm.
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Clinical information
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Factor XIII is responsible for stabilizing a fibrin clot. Factor XIII deficiency is an extremely rare autosomal recessive bleeding disorder. Homozygous individuals (FXIII <1%) experience soft tissue hemorrhage, hemarthrosis, and hematomas. Typically, as delayed bleeding start 24 to 48 hours after the initial hemostatic response to an injury. Heterozygous carriers may be asymptomatic; however, may cause recurrent spontaneous abortions in females.
Acquired factor XIII deficiency is rare, occurs as a result of development of autoantibodies and result in adult-onset bleeding.
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Specimen type / Specimen volume / Specimen container
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Plasma Na Cit. Platelet-poor plasma.
Specimen Volume:2.7 ml.
Container/Tube: Light-blue top (citrate)
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Collection instructions / Special Precautions / Timing of collection
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- Samples collected in HMC facilities MUST reach the coagulation laboratory within 1 hour of collection.
- Samples collected in non-HMC facilities / external clients: MUST reach coagulation laboratory within 1 hour of collection, if not applicable, centrifuge the whole blood and carefully remove the plasma (by pipette not by decanting) and send it in a temperature-controlled environment (18- 25 ºC) within 2 hours of centrifugation. If the transportation of the plasma can’t be within a maximum of 2 hours, prepare platelet-poor plasma as follows:
- Re-centrifuge the plasma again.
- Remove the top portion of plasma leaving approximately 250 ul in the bottom to discard.
- The double-centrifuged plasma should be aliquoted into labeled plastic tubes.
- Freeze immediately at -20 ºC or below
- Specimens must arrive frozen.
- If patient HCT is >55%, test will not be processed. The ordering Physician will be contacted to reorder the test and call the patient to go to Phlebotomy for recollection. Instruct the patient to inform the phlebotomy about his high HCT% , the phlebotomy will contact the lab to request a coagulation tube after adjusting amount of anticoagulant.
Note:
Collection of blood for coagulation testing through intravenous lines that have been previously flushed with heparin should be avoided, if possible. If the blood must be drawn through an indwelling catheter, possible heparin contamination and specimen dilution must be considered. When obtaining specimens from indwelling lines that may contain heparin, the line should be flushed with 5 mL of saline, and the first 5 mL of blood or 6-times the line volume (dead space volume of the catheter) be drawn off and not used for coagulation testing. For those specimens collected from a normal saline lock (capped off venous port) twice the dead space volume of the catheter and extension set should be discarded.
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Relevant clinical information to be provided
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Patient/family history of bleeding c disorder. History of chronic diseases .
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Storage and transport instructions
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Specimen Rejection Criteria
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Specimens with no label or missing required identification
Broken, leaking or contaminated specimen
Clotted samples
Under-filled or overfilled sample tubes.
Wrong sample container sample received
Improper specimen transport temperature (e.g. like specimens which are needed to be sent on ice)
Old specimen (test-dependent)
Grossly Hemolyzed sample (test-dependent)
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Biological reference intervals and clinical decision values
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For age > 18 years: : 70 – 140 %.
For age ≤18 years: :
* Reference Interval: Factor levels are expressed as percent of blood plasma concentration. By definition, pooled plasma contains 100 %(1unit/ml) of each factor.
* The reference range is quoted from literature. The reference range values have not been verified /established by lab.
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Minutes-4 Days
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4 Days-1 Months
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1 Months-6 Months
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6 Months-1 Years
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1 Years-5 Years
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5 Years-10 Years
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10 Years-18 Years
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27-131
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44-144
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63-152
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42-128
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71-139
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76-133
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64-133
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Factors affecting test performance and result interpretation
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No interference up to:
Triglycerides 149 mg/dL.
Hemoglobin 600 mg/dL 600.
Hemoglobin 600 mg/dL 600.
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Turnaround time / Days and times test performed / Specimen retention time
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For routine ordered test : 3 working days
For stat ordered test :
- During the Laboratory working hours from 0700 hours to 1500 hours (Sunday to Thursday): TAT is Within 8hrs.
- After duty hours, weekends and on holidays: TAT is within 12 hrs. with the following requirements:
- Laboratory should be notified by telephone about the sending of a STAT sample.
- The sample should be hand-delivered to the central processing area and requesting them to deliver it immediately to the hematology coagulation lab.
Test is done : Daily.
Specimen retention time: NA
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