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25464 Plasminogen Activity, Plasma (PSGN)

Plasminogen Activity, Plasma (PSGN)
Test Code: PLGSO
Synonyms/Keywords
Plasminogen, Functional, Plasma
Useful For

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)

Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)​​
​No ​Platelet-poor Plasma ​Citrated Blue Top Tube (BTT) ​ ​1.0 mL ​0.5 mL ​
Collection Processing Instructions

1. Spin down, remove plasma, and spin plasma again.
2. Freeze specimen immediately at < or =-40 degrees 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 Stability Information
Specimen Type Temperature Time​​
​Citrated Plasma ​Frozen ​14 days
Rejection Criteria
​Hemolysis​Gross
​Lipemia​Gross
​Icterus​Gross

 

Interference

​​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

Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrument​​ation
​Mayo Clinic Laboratories ​Monday through Friday ​3 days ​Chromogenic
Reference Lab
Mayo Clinic Laboratories
Test Information

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. 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%.

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).

Reference Range Information
75-140%
Interpretation
Plasminogen activity <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.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comment​​s
85420​ ​ ​ ​ ​
Synonyms/Keywords
Plasminogen, Functional, Plasma
Ordering Applications
Ordering Application Description

​Cerner
​Plasminogen Activity, Plasma (PSGN)​
​COM
​Plasminogen Activity, Plasma (PSGN)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)​​
​No ​Platelet-poor Plasma ​Citrated Blue Top Tube (BTT) ​ ​1.0 mL ​0.5 mL ​
Collection Processing

1. Spin down, remove plasma, and spin plasma again.
2. Freeze specimen immediately at < or =-40 degrees 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 Stability Information
Specimen Type Temperature Time​​
​Citrated Plasma ​Frozen ​14 days
Rejection Criteria
​Hemolysis​Gross
​Lipemia​Gross
​Icterus​Gross

 

Interference

​​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

Useful For

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)

Reference Range Information
75-140%
Interpretation
Plasminogen activity <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.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrument​​ation
​Mayo Clinic Laboratories ​Monday through Friday ​3 days ​Chromogenic
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comment​​s
85420​ ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.