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On laboratory problems in diagnosing mild von Willebrand's disease
M Blombäck1, P Eneroth, O Andersson
1Department of Clinical Chemistry and Blood Coagulation, Karolinska Hospital, Stockholm, Sweden.
American Journal of Hematology
|June 1, 1992
Summary
Diagnosing mild von Willebrand
Area of Science:
- Hematology
- Clinical Diagnostics
Background:
- Von Willebrand's disease (vWD) diagnosis, particularly type I, is challenging due to variable factor levels.
- von Willebrand factor antigen (vWF:Ag) and Factor VIII levels fluctuate, complicating accurate assessment.
Purpose of the Study:
- To highlight the diagnostic difficulties in mild von Willebrand's disease (vWD) type I.
- To investigate the variability of vWF:Ag and Factor VIII levels in healthy individuals.
Main Methods:
- Monitoring vWF:Ag, ristocetin cofactor, and Factor VIII levels over one month in healthy volunteers.
- Analyzing the coefficients of variation (CV) for vWF:Ag and the ratio of Factor VIII to vWF:Ag.
Main Results:
- Some healthy females exhibited vWF:Ag levels low enough to suggest vWD type I intermittently.
- Significant variability (CVs up to 43%) in vWF:Ag was observed, even in non-diseased individuals.
- The ratio of Factor VIII to vWF:Ag also showed considerable variation.
Conclusions:
- Accurate diagnosis of mild vWD type I is difficult due to inherent factor level variability.
- The follicular phase may provide a more representative vWF:Ag and ristocetin cofactor level in females.
- Sampling during the follicular phase is suggested for improved vWD type I diagnosis in females.