Bethesda Inhibitor
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 |
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.