Test Catalog

Test Id : PSGN

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Plasminogen Activity, Plasma

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating patients with ligneous conjunctivitis (strong association with homozygous plasminogen deficiency)

 

Evaluating fibrinolysis, in combination with other components of the fibrinolytic system (fibrinogen, tissue plasminogen-activator-inhibitor, and d-dimers)

Method Name
A short description of the method used to perform the test

Chromogenic

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Plasminogen Activity, P

Aliases
Lists additional common names for a test, as an aid in searching

Plasminogen, Functional, Plasma

Specimen Type
Describes the specimen type validated for testing

Plasma Na Cit

Ordering Guidance

Coagulation testing is highly complex, often requiring the performance of multiple assays and correlation with clinical information. For that reason, we suggest ordering AATHR / Thrombophilia Profile, Plasma and Whole Blood.

Necessary Information

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

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Specimen Type: Platelet-poor plasma

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

Submission Container/Tube: Plastic vial (polypropylene preferred)

Specimen Volume: 1 mL

Collection Instructions:

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

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

3. Aliquot plasma into separate plastic vial leaving 0.25 mL in the bottom of centrifuged vial.

4. Freeze plasma immediately (no longer than 4 hours after collection) at -20 degrees C or, ideally at -40 degrees C or below.

Additional Information:

1. A 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.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

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

Useful For
Suggests clinical disorders or settings where the test may be helpful

Evaluating patients with ligneous conjunctivitis (strong association with homozygous plasminogen deficiency)

 

Evaluating fibrinolysis, in combination with other components of the fibrinolytic system (fibrinogen, tissue plasminogen-activator-inhibitor, and d-dimers)

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

During the formation of a hemostatic (fibrin) plug, biochemical mechanisms are initiated to limit the extent of the hemostatic process at the site of injury and maintain vascular patency. This process of fibrinolysis is defined as the plasmin-mediated degradation of fibrin. Plasmin limits the extent of the hemostatic process at the site of vessel injury.

 

Plasmin is generated from its precursor, plasminogen, by plasminogen activators (ie, tissue plasminogen-activator: tPa; urokinase-type plasminogen activator: uPa). Plasminogen is a single-chain glycoprotein that is synthesized in the liver and has a biologic half-life of approximately 2 days.(1) Deficiency of plasminogen may be inherited or acquired. Persons with congenital plasminogen deficiency are at an increased risk for development of an ocular condition called ligneous conjunctivitis. Congenital deficiency of plasminogen is autosomally transmitted and rare in the general population, with a prevalence of approximately 0.4%.(2)

 

Based on the results of functional and immunologic (antigenic) assays, 2 types of plasminogen deficiency have been identified:

-Quantitative deficiency (type I)-defined by a corresponding decrease in both plasminogen activity and antigen level

-Functional deficiency (type II)-caused by a normally synthesized but dysfunctional plasminogen

This plasminogen activity assay will identify both types of deficiency.

 

Acquired causes of plasminogen deficiency include consumption such as with thrombolytic therapy (urokinase, tPa) or disseminated intravascular coagulation/intravascular coagulation and fibrinolysis (DIC/ICF), or decreased synthesis (liver disease).(1)

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

75-140%

Interpretation
Provides information to assist in interpretation of the test results

Plasminogen activity below 75% may represent a congenital deficiency state, if acquired deficiency can be excluded.

 

Hereditary abnormalities of plasminogen (deficiency or dysfunction) are very uncommon.

 

Acquired causes of plasminogen deficiency are much more common and may be the result of consumption due to thrombolytic therapy or intravascular coagulation and fibrinolysis or decreased synthesis (ie, liver disease).

 

Plasminogen levels are low at birth (approximately 50% of adult normal level) and reach adult levels at 6 months of age.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Proper preparation of the blood (plasma) specimen is extremely important to help ensure accuracy of results and interpretation.

 

Plasminogen results are potentially affected by:

-Elevated levels of fibrinogen

-Heparin (unfractionated or low-molecular-weight) >4 U/mL

-Fibrin degradation products (FDP) >30 mg/dL

-Hemoglobin >200 mg/dL

-Bilirubin >20 mg/dL

-Triglycerides >1000 mg/dL

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Bachman F. Plasminogen-plasmin enzyme system. In: Coman RW, Hirsh J, Marder VJ, et al, eds. Homeostasis and Thrombosis. Lippencott; 2001:275-320

2. Mehta R, Shapiro AD. Plasminogen deficiency. Haemophilia. 2008;14(6):1261-1268

3. Andrews M. The hemostatic system in the infant. In: Nathan DG, Oski FA, eds. Hematology of Infancy and Childhood. Vol 1. 4th ed. WB Saunders Company; 1993:115-153

4. Chandler W. Diagnosis of fibrinolytic disorder. In: Kottke-Marchant Wiley K, ed. Laboratory Hematology Practice. Blackwell Publishing; 2012:460-467

5. Favaloro EJ and Lippi G. eds. Hemostasis and Thrombosis: Methods and Protocols. 1st ed. Humana Press; 2017

Method Description
Describes how the test is performed and provides a method-specific reference

This assay is performed using the HemosIL Plasminogen Kit on the ACL TOP instrument. The method is an automated chromogenic assay in which an excess of streptokinase in the presence of fibrinogen is added to sample plasma containing plasminogen. A plasminogen-streptokinase complex is formed. The complex catalyzes the splitting of p-nitroaniline (pNA) from the substrate S-2403 pyroGlu-Phe-Lys-pNAHCl. Under these conditions the enzymatic activity of the complex is not inhibited by plasma inhibitors. The rate at which the pNA is released is measured kinetically at 405 nm and is directly proportional to the plasminogen level in the test specimen. The concentration of plasminogen is calculated from a standard curve prepared from reference plasma dilutions.(Package insert: HemosIL Plasminogen. Instrumentation Laboratory Company; 03/2019)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

3 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

7 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

85420

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
PSGN Plasminogen Activity, P 28660-9
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
PSGN Plasminogen Activity, P 28660-9

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports