Bethesda Inhibitor | Cleveland Clinic Laboratories

Bethesda Inhibitor Print

Test Mnemonic

BETHDA

CPT Codes

85335 - QTY (1)
85240 - QTY (1)
85210 - QTY (1)
85220 - QTY (1)
85230 - QTY (1)
85250 - QTY (1)
85260 - QTY (1)
85270 - QTY (1)

Aliases

Factor IX Inhibitor
Factor VIII Inhibitor
Inhibitor Assay

Includes

Bethesda Units

Performing Laboratory

Cleveland Clinic Laboratories

Specimen Requirements

Volume	Type	Container	Collect Temperature	Transport Temperature	Special Instructions
1 mL	Plasma	Sodium citrate (Lt. Blue)		Frozen	Send two 1 mL aliquots

Stability

Environmental Condition	Description
Ambient	4 hours
Refrigerated	Unacceptable
Frozen	14 days at -20 C; 6 months at -70 C

Days Performed

Mon - Fri

Turnaround Time

1 - 3 days

Methodology

Name	Description
Clotting Assay

Reference Range

Bethesda Inhibitor
Sex	Age From	Age To	Type	Range	Range Unit
	Years	99 Years	Normal	< or = 0.4	Inhib Unit
Factor II Assay
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	29 - 72	%
	2 Days	5 Days	Normal	36 - 96	%
	6 Days	30 Days	Normal	37 - 106	%
	1 Months	3 Months	Normal	50 - 109	%
	4 Months	11 Months	Normal	66 - 120	%
	1 Years	5 Years	Normal	78 - 120	%
	6 Years	10 Years	Normal	74-111	%
	11 Years	16 Years	Normal	67-108	%
	17 Years	99 Years	Normal	77-151	%
	Years	99 Years	Urgent	After Pathologist Review: < 5	%
Factor IX Assay
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	21 - 97	%
	2 Days	5 Days	Normal	21 - 97	%
	6 Days	30 Days	Normal	29 - 86	%
	1 Months	3 Months	Normal	29 - 120	%
	4 Months	11 Months	Normal	50 - 144	%
	1 Years	5 Years	Normal	66 - 110	%
	6 Years	10 Years	Normal	88 - 95	%
	11 Years	16 Years	Normal	83 - 130	%
	17 Years	99 Years	Normal	77 - 173	%
	Years	99 Years	Urgent	After Pathologist Review: < 5	%
Factor V Assay
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	42 - 100	%
	2 Days	5 Days	Normal	53 - 134	%
	6 Days	30 Days	Normal	73 - 124	%
	1 Months	3 Months	Normal	57 - 122	%
	4 Months	11 Months	Normal	65 - 118	%
	1 Years	5 Years	Normal	93 - 118	%
	6 Years	10 Years	Normal	74 - 108	%
	11 Years	16 Years	Normal	65 - 92	%
	17 Years	99 Years	Normal	73 - 139	%
	Years	99 Years	Urgent	After Pathologist Review: < 5	%
Factor VII Assay
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	23 - 116	%
	2 Days	5 Days	Normal	29 - 160	%
	6 Days	30 Days	Normal	35 - 154	%
	1 Months	3 Months	Normal	32 - 160	%
	4 Months	11 Months	Normal	39 - 142	%
	1 Years	5 Years	Normal	45 - 130	%
	6 Years	10 Years	Normal	43 - 134	%
	11 Years	16 Years	Normal	48 - 129	%
	17 Years	99 Years	Normal	55 - 160	%
	Years	99 Years	Urgent	After Pathologist Review: < 5	%
Factor VIII Assay
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	22 - 207	%
	2 Days	5 Days	Normal	22 - 179	%
	6 Days	30 Days	Normal	26 - 182	%
	1 Months	3 Months	Normal	34 - 145	%
	4 Months	11 Months	Normal	38 - 127	%
	1 Years	5 Years	Normal	59 - 165	%
	6 Years	10 Years	Normal	58 - 153	%
	11 Years	16 Years	Normal	53 - 152	%
	17 Years	99 Years	Normal	50 - 173	%
	Years	99 Years	Urgent	After Pathologist Review: < 5	%
Factor VIII Chromogenic
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	22-179	%
	2 Days	5 Days	Normal	22-155	%
	6 Days	30 Days	Normal	26-158	%
	1 Months	3 Months	Normal	34-126	%
	4 Months	11 Months	Normal	38-110	%
	1 Years	5 Years	Normal	59-143	%
	6 Years	10 Years	Normal	58-133	%
	11 Years	16 Years	Normal	53-132	%
	17 Years	999 Years	Normal	50-150	%
Factor X Assay
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	15 - 73	%
	2 Days	5 Days	Normal	23 - 85	%
	6 Days	30 Days	Normal	38 - 93	%
	1 Months	3 Months	Normal	43 - 115	%
	4 Months	11 Months	Normal	46 - 127	%
	1 Years	5 Years	Normal	61 - 124	%
	6 Years	10 Years	Normal	57 - 108	%
	11 Years	16 Years	Normal	52 - 126	%
	17 Years	99 Years	Normal	73 - 163	%
	Years	99 Years	Urgent	After Pathologist Review: < 5	%
Factor XI Assay
Sex	Age From	Age To	Type	Range	Range Unit
	Days	1 Days	Normal	10 - 91	%
	2 Days	5 Days	Normal	23 - 120	%
	6 Days	30 Days	Normal	27 - 109	%
	1 Months	3 Months	Normal	42 - 134	%
	4 Months	11 Months	Normal	39 - 185	%
	1 Years	5 Years	Normal	57 - 207	%
	6 Years	10 Years	Normal	53 - 165	%
	11 Years	16 Years	Normal	51 - 134	%
	17 Years	99 Years	Normal	68 - 175	%
	Years	99 Years	Urgent	After Pathologist Review: < 5	%

Special Info

Indicate coagulation factor to be tested. 3.2% sodium citrate is the preferred anticoagulant recommended by NCCLS. If inhibitor to porcine Factor VIII is needed, please supply porcine Factor VIII with patient sample. Appropriate factor assay requested will be performed and billed when requesting a Bethesda inhibitor.

Clinical Info

Factor VIII inhibitor: Factor VIII inhibitors most commonly occur in patients with Factor VIII deficiency (Hemophilia A) after treatment with factor replacement. Factor VIII inhibitors can also arise de novo in the elderly in a patient with lymphoproliferative disorders, post-partum and a patient with automimmune disorders.Factor IX inhibitor: Most commonly occurs in a patient with Factor IX deficiency (Hemophilia B) after treatment with factor IX replacement. De novo Factor IX inhibitors can occur but are rare. Porcine Factor VIII Inhibitor: Useful to determine the cross reactivity of factor VIII inhibitor against porcine factor VIII. If a factor VIII inhibitor is suspected, this assay should be ordered in addition to Factor VIII inhibitor level if porcine factor VIII is a therapeutic option. Factor VIII inhibitor: Inhibitor titers < 5 Bethesda units are considered low titer inhibitors; those > or = 5 Bethesda units are considered high titer inhibitors. Porcine Factor VIII inhibitor: A high titer (> 5 Bethesda units) against Porcine Factor VIII may make Porcine Factor VIII ineffective as a potential therapy for a Factor VIII inhibitor.