aca

The first automated random-access analyser. When introduced by DuPont Chemical Diagnostics division in 1968, the aca had a menu of 8 tests; the current generation has a menu of more than 100.

ACA

Abbreviation for:
acetoacetate
acute cutaneous anaphylaxis
acquired child aphasia
acrodermatitis chronica atrophicans
acute cerebellar ataxia
adenylyl cyclase A
adrenal cortex autoantibodies
aminocaproic acid
anterior cerebral artery
anterior communicating artery
anti-cardiolipin antibody
anti-centromere antibody
Area Cost Adjustment (Medspeak-UK)

aca

Lab medicine The very first automated random-access analyzer. See Random access analyzer.

Antibodies, Cardiolipin, Immunoglobulin A, Immunoglobulin G, and Immunoglobulin M

Synonym/acronym: Antiphospholipid antibody, lupus anticoagulant, LA, ACA.

Common use

To detect the presence of antiphospholipid antibodies, which can lead to the development of blood vessel problems and complications including stroke, heart attack, and miscarriage.

Specimen

Serum (1 mL) collected in a red-top tube.

Normal findings

(Method: Immunoassay, enzyme-linked immunosorbent assay [ELIS])

IgA (APL = 1 unit IgA phospholipid)	IgG (GPL = 1 unit IgG phospholipid)	IgM (MPL = 1 unit IgM phospholipid)
Negative: 0–11 APL	Negative: 0–14 GPL	Negative: 0–12 MPL
Indeterminate: 12–19 APL	Indeterminate: 15–19 GPL	Indeterminate: 13–19 MPL
Low-medium positive: 20–80 APL	Low-medium positive: 20–80 GPL	Low-medium positive: 20–80 MPL
Positive: Greater than 80 APL	Positive: Greater than 80 GPL	Greater than 80 MPL

Description

Anticardiolipin (ACA) is one of several identified antiphospholipid antibodies. ACAs are of IgG, IgM, and IgA subtypes, which react with proteins in the blood that are bound to phospholipid and interfere with normal blood vessel function. The two primary types of problems they cause are narrowing and irregularity of the blood vessels and blood clots in the blood vessels. ACAs are found in individuals with lupus erythematosus, lupus-related conditions, infectious diseases, drug reactions, and sometimes fetal loss. ACAs are often found in association with lupus anticoagulant. Increased antiphospholipid antibody levels have been found in pregnant women with lupus who have had miscarriages. β₂ Glycoprotein 1, or apolipoprotein H, is an important facilitator in the binding of antiphospholipid antibodies like ACA. A normal level of β₂ glycoprotein 1 is 19 units or less when measured by ELISA assays. β₂Glycoprotein 1 measurements are considered to be more specific than ACA because they do not demonstrate nonspecific reactivity as do ACA in sera of patients with syphilis or other infectious diseases. The combination of noninflammatory thrombosis of blood vessels, low platelet count, and history of miscarriage is termed antiphospholipid antibody syndrome and is documented as present if at least one of the clinical and one of the laboratory criteria are met.

Clinical criteria

Vascular thrombosis confirmed by histopathology or imaging studies
Pregnancy morbidity defined as either one or more unexplained deaths of a morphologically normal fetus at or beyond the 10th week of gestation
One or more premature births of a morphologically normal neonate before the 34th week of gestation due to eclampsia or severe pre-eclampsia
Three or more unexplained consecutive spontaneous abortions before the 10th week of gestation

Laboratory criteria (all measured by a standardized ELISA, according to recommended procedures)

ACA IgG, or IgM, detectable at greater than 40 units on two or more occasions at least 12 wk apart
Lupus anticoagulant (LA) detectable on two or more occasions at least 12 wk apart
Anti-β₂glycoprotein 1 antibody, IgG, or IgM detectable on two or more occasions at least 12 wk apart

This procedure is contraindicated for

N/A

Indications

Assist in the diagnosis of antiphospholipid antibody syndrome

Potential diagnosis

Increased in

While ACAs are observed in specific diseases, the exact mechanism of these antibodies in disease is unclear. In fact, the production of ACA can be induced by bacterial, treponemal, and viral infections. Development of ACA under this circumstance is transient and not associated with an increased risk of antiphospholipid antibody syndrome. Patients who initially demonstrate positive ACA levels should be retested after 6 to 8 wk to rule out transient antibodies that are usually of no clinical significance.
Antiphospholipid antibody syndrome
Chorea
Drug reactions
Epilepsy
Infectious diseases
Mitral valve endocarditis
Patients with lupuslike symptoms (often antinuclear antibody–negative)
Placental infarction
Recurrent fetal loss (strong association with two or more occurrences)
Recurrent venous and arterial thromboses
SLE

Decreased in

N/A

Critical findings

N/A

Interfering factors

Drugs that may increase anticardiolipin antibody levels include chlorpromazine, penicillin, procainamide, phenytoin, and quinidine.
Cardiolipin antibody is partially cross-reactive with syphilis reagin antibody and lupus anticoagulant. False-positive rapid plasma reagin results may occur.

Nursing Implications and Procedure

Potential nursing problems

Problem	Signs and Symptoms	Interventions
Fear (Related to possible loss of potential child; disability; death)	Verbalization of fear; restlessness; increased tension; continuous questioning; increased blood pressure, heart rate, respiratory rate	Provide specific and culturally appropriate education; assist the patient and family to recognize effective coping strategies; assist the patient to acknowledge fear; provide a safe environment to decrease fear; explore cultural influences that may enhance fear; utilize therapeutic touch as appropriate to decrease fear; collaborate with social services to address specific medical problems associated with fear
Grief (Related to placental infarction associated with placental cell death resulting in loss of potential child)	Apparent psychological and emotional distress; withdrawal; detachment; loss of appetite; refusal to participate in activities of daily living; anger; blame	Assess decision-making ability; encourage expression of grief; provide contact information for grief support group; assist to identify current support group; provide social services referral as appropriate; allow the patient to recall the loss and express feelings
Spirituality (Related to significant loss; fear of death; debilitation disease process)	Forgiveness; acceptance; anger at spiritual leaders; expressed feelings of hopeless, powerlessness; abandonment; refusals or inability to participate in spiritual activities (prayer); expresses feelings over lack of meaning with life or serenity	Encourage the verbalization of feelings in a safe nonjudgmental environment; assess the desire for contact from associated spiritual leader; foster a supportive relationship with the patient and family; encourage a display of objects (spiritual, religious) that provide emotional relief; asses for expressions of hope
Family process (Related to altered role performance secondary to disease progression)	Inability to perform in supportive family role; alteration in family finances; change in communication patterns; change in the assignment of family tasks and the performance of those tasks; alterations in intimacy	Family counseling; facilitating opportunities for the patient and family to express their feelings; assess the patient and family perception of the problems; evaluate patient and family weaknesses, strengths, and coping strategies; help the family and patient break down concerns into manageable parts

Pretest

Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
Patient Teaching: Inform the patient this test can assist in evaluating the amount of potentially harmful circulating antibodies.
Obtain a history of the patient’s complaints, including a list of known allergens, especially allergies or sensitivities to latex.
Obtain a history of the patient’s hematopoietic, immune, and reproductive systems; symptoms; and results of previously performed laboratory tests and diagnostic and surgical procedures.
Obtain a list of the patient’s current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values online at DavisPlus).
Review the procedure with the patient. Inform the patient that specimen collection takes approximately 5 to 10 min. Address concerns about pain and explain that there may be some discomfort during the venipuncture.
Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.
Note that there are no food, fluid, or medication restrictions unless by medical direction.

Intratest

Potential complications: N/A
Avoid the use of equipment containing latex if the patient has a history of allergic reaction to latex.
Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement.
Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection. Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection. Perform a venipuncture.
Remove the needle and apply direct pressure with dry gauze to stop bleeding. Observe/assess venipuncture site for bleeding or hematoma formation and secure gauze with adhesive bandage.
Promptly transport the specimen to the laboratory for processing and analysis.

Post-Test

Inform the patient that a report of the results will be made available to the requesting health-care provider (HCP), who will discuss the results with the patient.
Recognize anxiety related to test results, and be supportive of fear of shortened life expectancy. Discuss the implications of abnormal test results on the patient’s lifestyle. Provide teaching and information regarding the clinical implications of the test results, as appropriate. Educate the patient regarding access to counseling services. Provide contact information, if desired, for the Lupus Foundation of America (www.lupus.org).
Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient’s symptoms and other tests performed.
Patient Education
- Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP.
- Answer any questions or address any concerns voiced by the patient or family.
Expected Patient Outcomes
- Knowledge
- States understanding that fetal loss may be associated with placental infarct.
- States understanding of the importance in identifying a support system that can assist with coping with the spiritual distress of grief and loss.
- Skills
- Attends recommended grief counseling for emotional and psychological support related to fetal loss.
- Actively participates in the provision of self-care associated with the activities of daily living.
- Attitude
- Seeks assistance from spiritual leader to relieve emotional distress associated with loss of potential child, or loss of function secondary to disease process.
- Agrees to listen to the designated spiritual leader to assist in decreasing grief, loss.

Related Monographs

Related tests include ANA, CBC, CBC platelet count, fibrinogen, lupus anticoagulant antibodies, protein C, protein S, and syphilis serology.
See the Hematopoietic, Immune, and Reproductive systems tables at the end of the book for related tests by body system.

Patient discussion about aca

Q. What is the difference between alcoholism, alcohol abuse and alcohol dependent? A. Alcoholism is the high carve for drinking without caring for negative results it will have on physical, mental, emotional and social life. A binge drinker who continues to drink even though the problem has started in his normal life will lead to alcohol abuse and he may start the journey for alcoholism. In alcohol dependence the drinker steps up from the alcohol abuse and the crave increases in spite of the biggest problem on head. We can say that alcohol dependence is alcoholism.

Q. My son who is an alcohol abuse is undergoing treatment? My son who is an alcohol abuse is undergoing treatment. He stops his medicines in the middle of the treatment and restart taking alcohol. Doctor had warned to stop consuming alcohol in excess. With heavy drink he comes late at night and it frightens me. He drinks alcohol very badly and behaves violent also. He says he cannot stop. I am getting worried and was finding some information about the harm effects the excess drinking can bring to him?A. A)He must stop or reduce alcohol now. Allow him to drink in house so that he can be safe from some other dangerous situations which can mess his life. Once in home you can deal him well. At least you can make him to have his medicines. The adverse effects of alcohol consumption are liver damage, anemia, nerve damage, and pancreatitis. These can ruin his life.
http://www.youtube.com/watch?v=f2A3EPpIKWQ&eurl=http://www.imedix.com/health_community/vf2A3EPpIKWQ_alcohol_abuse_connection?q=alcohol%20abuse&feature=player_embedded

Q. Does alcohol drinking act as a catalyst of a problem? Does alcohol drinking act as a catalyst of a problem? My father has been battling depression and anxiety for many years and he used to drink in the past. Recently his behavior associated with drinking is visible and I strongly suspect that he is drinking again. Generally we get silly after drinking but my dad`s perception are altered in a negative way….A. Yes that’s true… when I drink my depression gets amplified. And this almost happens on the issues which hurts me. Sometimes it becomes self destructive. One should even look that it doesn’t harm anyone. Keep him under observation for 3 days and if the problem persists, then you must take him to a doctor.

More discussions about aca

ACA

Acronym	Definition
ACA➣Affordable Care Act
ACA➣American Chiropractic Association
ACA➣American Correctional Association
ACA➣American Camp Association
ACA➣Arms Control Association
ACA➣American Counseling Association
ACA➣American Camping Association
ACA➣American Canoe Association
ACA➣American Cable Association
ACA➣American Culture Association
ACA➣Amputee Coalition of America
ACA➣A Current Affair
ACA➣Australian Communications Authority
ACA➣Affordable Care Act of 2010
ACA➣Adobe Certified Associate
ACA➣Assistant City Attorney
ACA➣Air Canada (ICAO code)
ACA➣American Cycling Association
ACA➣Anterior Communicating Artery (blood vessel)
ACA➣American Crystallographic Association
ACA➣Arts and Cultural Attractions (Louisville, KY)
ACA➣American Citizens Abroad (various locations)
ACA➣Angel Capital Association (trade association)
ACA➣Atheist Community of Austin
ACA➣Action Communautaire Autonome (French: Autonomous Community Action)
ACA➣Arizona Commission on the Arts
ACA➣Atlantic Center for the Arts (New Smyrna Beach, FL)
ACA➣Advisory Commission on Aging (Alameda, CA)
ACA➣Aliphatic Carboxylic Acid
ACA➣Adult Children of Alcoholics
ACA➣Anomalous Coronary Artery (congenital malformation)
ACA➣Adventure Cycling Association (Missoula, Montana)
ACA➣Alpine Canada Alpin (racing)
ACA➣Anti-Corruption Agency (Malaysia)
ACA➣Annual Catholic Appeal
ACA➣Association of Canadian Archivists
ACA➣Asynchronous Communication Adapter
ACA➣Auto Contingent Allegiance
ACA➣Adjacent Channel Attenuation
ACA➣Audio Content Architecture
ACA➣Agent Character
ACA➣Automatic Component Activation
ACA➣Audio Compression Algorithm
ACA➣Aspect Camera Assembly
ACA➣Anterior Cerebral Artery
ACA➣Academic Cooperation Association (Belgium)
ACA➣American Contemporary Art
ACA➣Armed Criminal Action
ACA➣Antioch-Pittsburg (Amtrak station code; Antioch, CA)
ACA➣Application Control Architecture (DEC)
ACA➣American Composers Alliance
ACA➣Alley Cat Allies
ACA➣Association of Collegiate Alumnae (American Association of University Women)
ACA➣Australian Consumers' Association
ACA➣Automóvil Club Argentino
ACA➣Atlantic Coast Airlines
ACA➣Aerospace Control Alert (US Air Force)
ACA➣American Collectors Association
ACA➣Autodesk Certified Associate
ACA➣Acer Computer Australia (est. 1990)
ACA➣Army Contracting Agency
ACA➣Appalachian College Association
ACA➣Applications of Computer Algebra
ACA➣Area Character Appraisal (historical neighborhoods)
ACA➣Area Cost Adjustment (UK)
ACA➣Australian Cricketers' Association
ACA➣American Communication Association
ACA➣Asociación Cristiana (Christian Association, Guatemala)
ACA➣Association of Consulting Actuaries
ACA➣Australian Coal Association
ACA➣American Council on Alcoholism
ACA➣Automobile Club Albania
ACA➣American Cornhole Association
ACA➣Anglican Church in America
ACA➣Australian Centre for Astrobiology
ACA➣Additional Central Assistance
ACA➣Anglo Coal Australia
ACA➣Acción Católica Argentina (Spanish)
ACA➣American Civic Association
ACA➣Anticardiolipin Antibody
ACA➣Agricultural Credit Association
ACA➣American Compensation Association
ACA➣Anisotropic Conductive Adhesive (fine-pitch chip-on-flex packages for LCD applications)
ACA➣Ammoniacal Copper Arsenate (wood preservative)
ACA➣Airspace Control Authority
ACA➣Academic Building
ACA➣Academy of Certified Archivists
ACA➣Aircraft Carrier Alliance
ACA➣Agriculture Council of America
ACA➣Air Care Alliance
ACA➣Amazon Conservation Association (Washington, DC)
ACA➣Avis de Changement d'Adresse (Canada Post)
ACA➣Association of Chartered Accountants
ACA➣Action Collection Agency (various locations)
ACA➣Australian Counselling Association (Grange, QLD, Australia)
ACA➣Associazione Cernuschese Astrofili (Italian: Cernusco Amateur Astronomers Association; Cernusco, Italy)
ACA➣Adult Children Anonymous
ACA➣American Cichlid Association
ACA➣American Conference of Audioprosthology (hearing)
ACA➣Agri Coll Association (French agricultural toy association)
ACA➣Akita Club of America
ACA➣American Cryptogram Association
ACA➣American Country Award (music)
ACA➣Australian Citizenship Act
ACA➣Author Co-Citation Analysis
ACA➣Associate of the Institute of Chartered Accountants
ACA➣Allied Cash Advance
ACA➣After Contract Award
ACA➣Automóbil Club d'Andorra (Catalan: Automobile Club of Andorra)
ACA➣Alberta Construction Association
ACA➣Anti-Counterfeiting Association (Japan)
ACA➣Aluminum Company of America
ACA➣American Chain Association
ACA➣Asociación Campesina de Arauca (Spanish: Arauca Peasants Association; Arauca, Colombia)
ACA➣Airspace Coordination Area
ACA➣Association of Consulting Architects
ACA➣Agent of Certification Authority (US Army)
ACA➣Alaska Conservation Alliance
ACA➣Application Continuity Appliance (Teneros)
ACA➣Adoption Coordinating Agency (India)
ACA➣Agence Culturelle d'Alsace (French: Alsace Cultural Agency)
ACA➣Avanade Connected Architecture (Avanade Inc.)
ACA➣Association for Communication Administration
ACA➣Ashiya Cosmopolitan Association (Hyogo, Japan)
ACA➣Air Commerce Act of 1926
ACA➣Arizona Contractors Association
ACA➣Administrative Cost Allowance (student financial aid)
ACA➣Air Commando Association
ACA➣Adaptive Channel Allocation
ACA➣American Cadet Alliance
ACA➣Alabama Cattlemen's Association
ACA➣Air Courier Association
ACA➣Associate Contractor Agreement
ACA➣Administrative Control Authority
ACA➣Agricultural Credit Act of 1987
ACA➣Anti-Capitalist Action (various organizations)
ACA➣Aircrew Association (UK)
ACA➣Australian Coastal Atlas
ACA➣Awassa College of Agriculture (Ethiopia)
ACA➣Agency for Cultural Affairs (Japan; est. 1968)
ACA➣American Conservation Association
ACA➣American Cuemakers Association
ACA➣Association of Chinese Americans
ACA➣Austrian Consultants Association (Austria)
ACA➣Association for the Calligraphic Arts
ACA➣Astronomie Centre Ardenne (French astronomy club)
ACA➣Air Clearance Authority
ACA➣Acapulco, Guerrero, Mexico - Alvarez International (Airport Code)
ACA➣Automatic Circuit Assurance
ACA➣Asynchronous Communications Adapter
ACA➣All Channel Alert (Canada)
ACA➣Allegheny Cycling Association
ACA➣Antarctic Conservation Act
ACA➣Architectural Cladding Association (UK)
ACA➣Airlift Clearance Authority
ACA➣American Creativity Academy (Kuwait)
ACA➣Allan Crawford Associates (Canada)
ACA➣Allocation Chômeur Âgé
ACA➣Association for Community Advocacy
ACA➣Association of Commercial Archaeologists
ACA➣Animal Charities of America
ACA➣Alzheimer's of Central Alabama
ACA➣Astronautics Corporation of America
ACA➣American Canine Association, Inc.
ACA➣Advanced Certification Administrator
ACA➣Advanced Combat Aircraft
ACA➣Average Case Analysis
ACA➣Association Canadienne d'Acoustique (Canadian Acoustical Association)
ACA➣Abduction Central Alert
ACA➣Athlétic Club Arles-Avignon (French football club)
ACA➣American Countertrade Association
ACA➣American Catahoula Association
ACA➣Australian Clogging Association
ACA➣Advanced Cargo Aircraft
ACA➣American Cheerleaders Association
ACA➣Access Control Agent
ACA➣Attitude Control Assembly
ACA➣Adjacent-Channel Attenuation
ACA➣American Coach Association
ACA➣Apple Certification Alliance
ACA➣American Culinary Alliance
ACA➣Avoids Cascading Aborts
ACA➣Adviser Compliance Associates, LLC
ACA➣Alberta Chess Association
ACA➣Arizona Cultural Academy (Phoenix, AZ)
ACA➣Alliance of Cambridge Advisors
ACA➣Archbishop's Catholic Appeal
ACA➣Alerting Communicators of America
ACA➣Alternate Command Authority
ACA➣Arizona Counselors Association
ACA➣Absolute Calibration Audit
ACA➣Adaptive Component Architecture
ACA➣Animal Care Attendant (veterinary)
ACA➣Associate of the Conference of Consulting Actuaries
ACA➣Amphibian Conservation Alliance
ACA➣American Chess Association
ACA➣American Craft Association
ACA➣Arts and Cultural Alliance
ACA➣Action Culturelle et Artistique (French: Artistic and Cultural Action; University of Paris VIII; France)
ACA➣Automobile Club d'Aix (French automobile club)
ACA➣Aero Club Albatross (Delaware, NJ)
ACA➣Artisan Contractors Association of America
ACA➣A36-A350 Corridor Alliance
ACA➣Academy for Culinary Arts
ACA➣Air Control Authority
ACA➣Applied Combinatorial Analysis
ACA➣Asynchronous Criticality Avoidance
ACA➣Allo Casse Auto (French automobile parts company)
ACA➣Adaptive Configuration Agent
ACA➣Australian Croquet Association Inc
ACA➣Assignment Control Authority
ACA➣Aéro-Club d'Abidjan (French; flying club; Ivory Coast)
ACA➣Asociación Casa Alianza (Marriage Alliance Association, Guatemala)
ACA➣American Carbohydrate Association
ACA➣Ambo College of Agriculture (Ethiopia)
ACA➣Advertising Council of America
ACA➣Anniston Chemical Activity (Anniston, Alabama)
ACA➣All Composite Aircraft
ACA➣Acquisition Capability Assessment
ACA➣Autonomous Cooperating Agent
ACA➣Application Control Account
ACA➣Automatic Conference Arranger
ACA➣Automatic Circuit Analyzer
ACA➣American Cuesports Alliance
ACA➣Auditeurs et Consultants Africains (French: African Auditors and Consultants)
ACA➣Asynchronous Cooperative Algorithm
ACA➣Average Coherence Approximation
ACA➣American Cheerleading Academy
ACA➣Aquadev Central Africa
ACA➣Amusement Corporation of America (carnivals and fairs)
ACA➣Alpine Côte d'Azur (French automobile club)
ACA➣Automated Circuit Assurance
ACA➣Agricultural Credits Act of 1928
ACA➣Aviation Club d'Avord (French poker club)
ACA➣Analysis of Collection Activity
ACA➣Airborne Collection Assembly
ACA➣Active Circulator Antenna
ACA➣Autobody Craftsmans Association
ACA➣Advanced Confidentiality Agreement
ACA➣Auto-Configuration Agent
ACA➣Autoclub Altena (Dutch; Belgian car club)
ACA➣Automatic Conference Arrangement
ACA➣Advisory Committee on Aero-ballistics
ACA➣All Call Answered (Sprint)
ACA➣Adaptive Computing Architecture
ACA➣Automatic Contrast Adjustment
ACA➣Advanced Commercial Airliner
ACA➣Association Chalonnaise d'Aquariophilie (French; aquarium enthusiasts' association)
ACA➣Advanced Contract Administrator
ACA➣Agent of the Certifying Authority (performs certification testing of systems)

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