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Coagulation

Coagulation laboratory tests

Antiplasmin assay


Reviewer: Jeremy Parsons, M.D. (see Reviewers page)
Revised: 19 June 2012, last major update June 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

General
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● Also called anti-alpha2-antiplasmin, plasmin inhibitor
● An uncommon assay usually sent to reference laboratories

Indications:
● Familial bleeding disorder, after ruling out more common bleeding disorders such as von Willebrand disease
● True alpha2-antiplasmin deficiency is a rare condition (<20 cases)
● Most cases are caused by inhibitors (antibodies)

Specimen:
● Plasma in citrate tube, without epsilon-aminocaproic acid, aprotinin, heparin or other fibrinolysis inhibitors

Reference range:
● Approximately 48-80 mg/dL, lower during first 5 days of life

Functional assays:
● Add specific amount of excess plasmin to patientís plasma, measure plasmin that is unbound to antiplasmin in patientís serum by detecting color change spectrophotometrically
● Amount of unbound plasmin detected is inversely proportional to patientís antiplasmin level

Antigenic (immunologic) assay:
● Patientís plasma in placed in the cylindrical well of an agarose gel containing antiplasmin antibody, which defuses into the well and forms an antigen-antibody complex and precipitin ring
● The size of the ring is proportional to the patientís antiplasmin

Acquired causes of decreased antiplasmin:
● Liver disease, thrombolytic therapy, DIC

Additional references
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J Thromb Haemost 2007;5:812

End of Coagulation > Coagulation laboratory tests > Antiplasmin assay


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