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Protein C Activity

Hormone/ Element
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Report in 48Hrs

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At Home

nofastingrequire

No Fasting Required

Details

Measures the functional activity of Protein C in the blood, assessing its ability to regulate clot formation

₹3,750₹5,350

30% OFF

Protein C Activity Test - Comprehensive Medical Guide

  • Why is it done?
    • Measures functional activity of Protein C, a natural anticoagulant protein that helps prevent excessive blood clotting by inactivating blood clotting factors V and VIII
    • Ordered to evaluate patients with personal or family history of blood clots (thrombosis or thromboembolism)
    • Used to diagnose Protein C deficiency, a hereditary or acquired clotting disorder that increases risk of venous thromboembolism, deep vein thrombosis (DVT), and pulmonary embolism (PE)
    • Performed during evaluation of recurrent unexplained thrombosis or thrombosis in unusual sites (mesenteric, cerebral, or portal veins)
    • Indicated in patients with warfarin-induced skin necrosis to assess for underlying Protein C deficiency
    • Used to monitor patients with known Protein C deficiency or those on anticoagulation therapy
  • Normal Range
    • Normal Range: 70-130% of normal activity (or 70-130 IU/mL)
    • Units of Measurement: Percentage (%) of normal activity or International Units per milliliter (IU/mL)
    • Result Interpretation:
    • Normal result (70-130%): Adequate Protein C activity; normal anticoagulant function; low risk for thrombosis related to Protein C deficiency
    • Low result (<70%): Suggests Protein C deficiency; increased risk for thrombotic events; may indicate Type I (quantitative) or Type II (qualitative) deficiency
    • Borderline result (60-70%): Warrants further testing and clinical correlation; may require family screening
    • Significantly elevated result (>130%): Rarely clinically significant; unlikely to represent true elevation in activity
    • Laboratory Variation: Reference ranges may vary slightly between laboratories; consult laboratory report for specific reference values
  • Interpretation
    • Low Protein C Activity (<70%):
    • Indicates Type I or II Protein C deficiency; both hereditary and acquired causes possible; associated with hypercoagulable state and increased thrombotic risk
    • Hereditary Protein C Deficiency:
    • Autosomal dominant condition; heterozygous individuals have ~50% activity; homozygous individuals have <10% activity with severe thrombotic manifestations
    • Acquired Protein C Deficiency:
    • May occur with liver disease, vitamin K deficiency, disseminated intravascular coagulation (DIC), acute infection/sepsis, warfarin therapy, malignancy, or antithrombin III deficiency
    • Factors Affecting Results:
    • Anticoagulation therapy (warfarin/heparin) may falsely lower activity; acute thrombotic events can transiently decrease levels; pregnancy, oral contraceptives, and hormone replacement therapy may elevate levels
    • Recent thromboembolism can temporarily decrease Protein C activity; medication interactions and timing of blood draw important for accuracy
    • Clinical Significance:
    • Significantly elevated thrombotic risk with activity <50%; moderate risk with activity 50-70%; distinguishing hereditary from acquired deficiency crucial for management and family screening decisions
  • Associated Organs
    • Primary Organ Systems:
    • Vascular system and hemostatic (clotting) system; liver (primary site of Protein C synthesis); endothelial cells (Protein C activated at endothelial surface)
    • Commonly Associated Conditions with Abnormal Results:
    • Hereditary Protein C deficiency (Type I and II); deep vein thrombosis (DVT); pulmonary embolism (PE); thrombosis of mesenteric, cerebral, or portal veins
    • Warfarin-induced skin necrosis; neonatal purpura fulminans; disseminated intravascular coagulation (DIC); sepsis; liver cirrhosis
    • Diseases Diagnosed or Monitored:
    • Thrombophilia; hypercoagulable states; recurrent thromboembolism; spontaneous thrombosis in young patients; familial thrombotic disorders; investigation of thrombosis in unusual anatomical sites
    • Potential Complications of Protein C Deficiency:
    • Recurrent thromboembolism; life-threatening thrombotic complications; limb ischemia requiring amputation; mesenteric infarction; stroke; postphlebitic syndrome with chronic venous insufficiency; pregnancy-related thrombotic complications
    • Neonatal purpura fulminans in homozygous individuals; intracranial hemorrhage; paradoxical thromboembolism during anticoagulation initiation
  • Follow-up Tests
    • Initial Follow-up Tests (if Protein C Activity Low):
    • Protein C antigen level (quantitative test to differentiate Type I from Type II deficiency); Protein S activity and antigen; activated Protein C resistance testing (for Factor V Leiden)
    • Prothrombin time (PT) and activated partial thromboplastin time (aPTT); thrombin time; platelet count and fibrinogen level to assess overall hemostatic function
    • Antithrombin III activity (to rule out combined deficiency); Factor V and Factor VIII levels; D-dimer if acute thromboembolism suspected
    • Imaging Studies (if Thromboembolism Suspected):
    • Venography or compression ultrasound to evaluate for DVT; ventilation-perfusion scan or CT pulmonary angiography (CTPA) for PE evaluation
    • Genetic Testing:
    • DNA sequencing of PROC gene to identify mutations; molecular testing to confirm hereditary deficiency; recommended for family screening and genetic counseling purposes
    • Family Screening:
    • Protein C activity testing in first-degree relatives; especially important for parents and siblings; genetic counseling recommended
    • Monitoring During Treatment:
    • PT/INR monitoring if on warfarin; aPTT if on heparin; baseline and periodic Protein C activity if on Protein C replacement therapy; Doppler ultrasound follow-up for DVT resolution
    • Monitoring Frequency:
    • Initial assessment with repeat testing (after acute event resolves, off anticoagulation for 2 weeks); baseline Protein C activity established before initiating long-term anticoagulation; periodic assessment if suspected acquired cause
  • Fasting Required?
    • Fasting: NO - Fasting is not required for Protein C activity testing
    • Blood Draw Timing Considerations:
    • Ideally obtained at least 2 weeks after acute thrombotic event and after discontinuing anticoagulation therapy for baseline assessment; timing critical for accurate diagnosis of hereditary deficiency
    • Medications to Avoid/Consider:
    • Warfarin (Coumadin) causes falsely low Protein C levels; discontinue warfarin for 2 weeks prior to testing if possible; heparin therapy does not significantly affect Protein C activity
    • Estrogen-containing medications (oral contraceptives, hormone replacement therapy) may elevate Protein C levels; discuss with physician timing of testing in relation to estrogen use
    • Special Patient Preparation:
    • Patient may eat and drink normally before test; hydration not specifically restricted; arrive with minimal stress when possible as this affects clotting factors
    • Inform phlebotomist of pregnancy status (can affect results); report recent illness, infection, or surgery; notify of any bleeding or clotting symptoms
    • Sample Collection:
    • Venipuncture performed using standard technique; blood collected in sodium citrate tube (blue-top) according to laboratory protocol; proper fill volume critical for accurate results

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