Factor IX Activity With Inhibitor Reflex

Factor IX Inactivator; Factor IX Bethesda Titer

11 days

See individual activity test information for method information.

Test Includes:
This test includes factor IX Activity with reflex to factor IX inhibitor (Bethesda titer) when activity is less than or equal to 40%.

Special Instructions:
If the patient's hematocrit exceeds 55%, the volume of citrate in the collection tube must be adjusted. Refer to Coagulation Collection Procedures for directions. Do not draw from an arm with a heparin lock or heparinized catheter.

Causes for Rejection
Severe hemolysis; improper labeling; clotted specimen; specimen diluted with IV fluids; samples thawed in transit; improper sample type; sample out of stability

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This profile measures factor IX activity and reflexes to a measurement of factor IX inhibitor level (Bethesda titer) when the activity level is diminished to 40% or less.

Plasma

2 mL

Blue top (sodium citrate) tube

Ideally, the patient should not be on anticoagulant therapy. Avoid warfarin (Coumadin®) therapy for two weeks prior to the test and heparin, direct Xa and thrombin inhibitor therapies for about three days prior to testing.

Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate. Evacuated collection tubes must be filled to completion to ensure a proper blood-to-anticoagulant ratio. The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples unless the sample is collected using a winged (butterfly) collection system. With a winged blood collection set a discard tube should be drawn first to account for the dead space of the tubing and prevent under-filling of the evacuated tube. When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternative anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes.