Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

A2M
9270
biological half-life of approximately 3 days. It inactivates plasmin, the primary fibrinolytic enzyme
responsible for remodeling the fibrin thrombus, and binds fibrin, together with factor XIIIa, making the
clot more difficult to lyse. Absence of alpha-2 plasmin inhibitor results in uncontrolled
plasmin-mediated breakdown of the fibrin clot and is associated with increased risk of bleeding.
Useful For: Diagnosing congenital alpha-2 plasmin inhibitor deficiencies (rare) Providing a more
complete assessment of disseminated intravascular coagulation, intravascular coagulation and fibrinolysis,
or hyperfibrinolysis (primary fibrinolysis), when measured in conjunction with fibrinogen, fibrin D-dimer,
fibrin degradation products, soluble fibrin monomer complex, and plasminogen Evaluating liver disease
or the effects of fibrinolytic or antifibrinolytic therapy
Interpretation: Patients with congenital homozygous deficiency (with levels of or =50%)
which reach adult levels within 5 to 7 days postnatal.*
Healthy, premature infants (30-36 weeks gestation) may have mildly decreased levels which reach adult
levels in < or =90 days postnatal.*
*See Pediatric Hemostasis References in Coagulation Studies in Special Instructions.
Clinical References: 1. Lijnen HR, Collen D: Congenital and acquired deficiencies of components
of the fibrinolytic system and their relation to bleeding or thrombosis. Blood Coagul Fibrinolysis
1989;3:67-77 2. Francis RB Jr: Clinical disorders of fibrinolysis: A critical review. Blut 1989;59:1-14 3.
Aoki N: Hemostasis associated with abnormalities of fibrinolysis. Blood Rev 1989;3:11-17
Alpha-2-Macroglobulin, Serum
Clinical Information: Alpha-2-macroglobulin is a protease inhibitor and is 1 of the largest plasma
proteins. It transports hormones and enzymes, exhibits effector and inhibitor functions in the development
of the lymphatic system, and inhibits components of the complement system and hemostasis system.
Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when other lower molecular
weight proteins are lost and alpha-2-macroglobulin is retained because of its large size. In patients with
liver cirrhosis and diabetes, the levels are found to be elevated. Patients with acute pancreatitis exhibit low
serum concentrations which correlate with the severity of the disease. In hyperfibrinolytic states, after
major surgery, in septicemia and severe hepatic insufficiency, the measured levels of
alpha-2-macroglobulin are often low. Acute myocardial infarction patients with low
alpha-2-macroglobulin have been reported to have a significantly better prognosis with regard to the >1
year survival time.
Useful For: Evaluation of patients with nephrotic syndrome and pancreatitis
Interpretation: Values are elevated in the nephrotic syndrome in proportion to the severity of protein
loss (lower molecular weight). Values are low in proteolytic diseases such as pancreatitis.
Reference Values:
100-280 mg/dL
Clinical References: 1. McMahon MJ, Bowen M, Mayer AD, Cooper EH: Relation of
alpha-2-macroglobulin and other antiproteases to the clinical features of acute pancreatitis. Am J Surg
1984;147:164-170 2. Haines AP, Howarth D, North WR, et al: Haemostatic variables and the outcome of
myocardial infarction. Thromb Haemost 1983;50:800-803 3. Hofmann W, Schmidt D, Guder WG, Edel
HH: Differentiation of hematuria by quantitative determination of urinary marker proteins. Klin
Wochenschr 1991;69:68-75 4. Solerte SB, Adamo S, Viola C, et al: Acute-phase protein reactants pattern
and alpha 2 macroglobulin in diabetes mellitus. Pathophysiological aspects in diabetic microangiopathy.
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