Ordering Guidance

This test should be performed prior to treatment initiation and in the absence of therapy with complement inhibitors, such as eculizumab or ravulizumab. Complement inhibitors will affect performance of these assays.

For evaluating patients with possible thrombotic microangiopathies (TMA), the recommended first-tier test is ADM13 / ADAMTS13 Activity and Inhibitor Profile, Plasma. This test should be a second-tier test for TMA.

For patients who have received eculizumab or need to monitor response to eculizumab therapy, the recommended test is ECUMP / Eculizumab Monitoring Panel, Serum. Soluble membrane attack complex (sMAC) should not be used as a standalone assay to monitor eculizumab efficiency.

Specimen Required

Both plasma and serum are required for this test.

Patient Preparation:

1. Fasting preferred.

2. Samples should not be collected earlier than 48 hours following plasma exchange.

Supplies: Sarstedt Aliquot Tube 5 mL (T914)

Specimen Type: Plasma

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

Submission Container/Tube: 3 plastic vials

Specimen Volume: 1.5 mL in 3 plastic vials, each containing 0.5 mL

Collection Instructions:

1. Immediately after specimen collection, place the tube on wet ice.

2. Centrifuge; 1500 x g for 10 minutes at 4° C and aliquot plasma into plastic vial.

3. Freeze specimen within 30 minutes.

Specimen Type: Serum

Collection Container/Tube: Red top (serum gel/SST are not acceptable)

Submission Container/Tube: 3 plastic vials

Specimen Volume: 1.5 mL in 3 plastic vials, each containing 0.5 mL

Collection Instructions:

1. Immediately after specimen collection, place the tube on wet ice.

2. Centrifuge at 4° C and aliquot serum into 5 mL plastic vial.

3. Freeze specimen within 30 minutes.