HERMANN TEST CODE: 26-00490
CPT CODE: 85420
SPECIMEN REQUIREMENT: 5 mL blood (minimum 4.5 ml), blue top tube (sodium citrate), mixed well. Results would not be diagnostic if patient has been on fibrinolytic therapy.
TEST AVAILABILITY: Sent out by Hermann Laboratory to Colorado Coagulation Reference Laboratory. Reporting time in less than 7 days.
METHODOLOGY: Radial Immunodiffusion (RID)
CLINICAL UTILIZATION: Diagnosis of Dysfunctional Plasminogen
REFERENCE RANGE: 7.7-14.5 mg/dL
INTERPRETATION:
Plasminogen is a zymogen which is converted to plasmin by plasminogen activators or by thrombin. Plasmin is the major protease in the fibrinolytic system. Plasminogen deficiency results in a predisposition to thrombosis. It is an inherited disorder that occurs in two major forms: (a) reduced or absent production of a normal plasminogen , (b) production of an abnormal molecule in normal amount (dysfunctional form). Inheritance of both forms is autosomal recessive. Heterozygotes have approximately 40-60% of normal plasminogen activity while homozygotes have lower activity. Plasminogen abnormalities are considered a rare cause of thrombosis. Many reported cases note a precipitating event (e.g. infection or trauma) preceding the occurrence of thrombosis. Thrombosis usually occurs when plasminogen activity level is less than 40%.
Without ongoing thrombotic complications, patients with plasminogen deficiency usually have normal coagulation screen tests (PT, PTT, Fibrinogen, Thrombin Time, Platelet Count). Deficiency of Plasminogen should initially be investigated with a plasminogen functional assay. If the plasminogen functional assay is normal, plasminogen deficiency can be excluded. Only an abnormal functional plasminogen assay requires further testing with plasminogen antigen assay to rule out dysfunctional plasminogen.
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