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Test Code APSM Alpha-2 Plasmin Inhibitor, Plasma

Reporting Name

Alpha-2 Plasmin Inhibitor, P

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

Specimen Required

See Coagulation Studies 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. Spin down, remove plasma, and spin 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.

Specimen Type

Plasma Na Cit

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma Na Cit Frozen 14 days

Day(s) and Time(s) Performed

Monday through Friday; Varies

Seattle Children's Hospital Note:

TAT: 3 - 9 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Method Name

Hydrolysis of Synthetic Chromogenic Substrate, Colorimetric End point
Includes measurement of the function of antiplasmin, mostly alpha-2-antiplasmin, with slight interference
from alpha-2-macroglobulin.

Method Description

This assay is performed using the HemosIL Plasmin Inhibitor Kit on the Beckman Coulter ACL TOP. Patient plasma, containing alpha-2 plasmin inhibitor, is mixed with reagent containing excess plasmin. Plasmin activity in the reagent is rapidly inhibited by alpha-2 plasmin inhibitor. Residual plasmin activity is then measured using an amidolytic activity assay, in which residual plasmin lyses a synthetic chromogenic substrate and subsequently releases paranitroanline (detected at 405 nm) to a level that is inversely proportional to the amount of alpha-2 plasmin inhibitor in the sample.(Teger-Nilsson AC, Friberger P, Gyzander E: Determination of a new rapid plasmin inhibitor in human blood by means of a plasmin specific tripeptide substrate. Scand J Clin Lab Invest 1977;37:403-409)

Reference Values

Adults: 80-140%

Normal, full-term newborn infants may have borderline low or mildly decreased levels (≥50%) which reach adult levels within 5 to 7 days postnatal.*

Healthy, premature infants (30-36 weeks gestation) may have mildly decreased levels which reach adult levels in ≤90 days postnatal.*

*See Pediatric Hemostasis References in Coagulation Studies in Special Instructions.

Test 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


LOINC Code Information

Test ID Test Order Name Order LOINC Value
APSM Alpha-2 Plasmin Inhibitor, P 27810-1


Result ID Test Result Name Result LOINC Value
APSM Alpha-2 Plasmin Inhibitor, P 27810-1

Reject Due To


Mild OK; Gross reject


Mild OK; Gross reject






Special Instructions