Imperial Collage Healthcare

Antithrombin level

Test Background
Antithrombin has a powerful anticoagulant action in the presence of heparin, working by neutralising serine proteases, particularly thrombin and Xa. It acts more strongly against thrombin in the presence of higher molecular weight heparins, and against Xa with lower molecular weight heparins. A hereditary deficiency of antithrombin is accompanied by a high frequency of spontaneous thrombotic disorders. Hereditary antithrombin deficiencies are quantitative (type I) or qualitative (type II). The incidence of inherited deficiency has been estimated at between 1:2,000 and 1:5,000 in the normal population. In addition, a number of acquired deficiencies have also been described. An antithrombin assay is available as part of the thrombophilia screen.

Clinical Indications
Venous thromboembolism at a young age (including childhood) Recurrent venous thromboembolism Unusual site of thrombosis (eg. mesenteric, renal, portal veins, cerebral venous sinuses) Thrombosis during pregnancy or puerperium Recurrent superficial thrombophlebitis Arterial thrombosis at a young age (abruptio placentae, pre-term delivery) Neonatal purpura fulminars or massive thrombosis in newborn Perthe's disease of the lip Warfarin-induced skin necrosis

Reference Range

80-120 IU/dL

Sample Required
4 x 4.5 mL sodium citrate (pale blue top) adults4 x 1.8 mL sodium citrate (pale blue top) paediatrics

Turnaround Time
10-14 days

Special handling: avoid prolonged stasis during venepuncture. Sample must be received by lab within 2 hours of collection. Please note: samples will be rejected if underfilled, clotted, haemolysed or if patients are receiving anticoagulant therapy. Similarly, sampling is inappropriate within 4 weeks post-childbirth or during an acute phase inflammatory response. A discussion with a haematologist is advisable prior to requesting this and other thrombophilia tests. Requests may be subject to approval by haematology prior to testing.

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