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von Willebrand factor multimer patterns in pregnancy-induced hypertension
B Brenner1, E Zwang, M Bronshtein
1Hematology Institute, Ichilov Hospital, Tel-Aviv Medical Center, Israel.
Thrombosis and Haemostasis
|September 29, 1989
Summary
Pregnancy-induced hypertension (PIH) is linked to elevated levels of von Willebrand factor (vWF) multimers, potentially contributing to microangiopathy. These findings suggest a role for vWF in PIH pathogenesis.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Pathology
Background:
- Microangiopathy and platelet aggregation are observed in thrombotic thrombocytopenic purpura (TTP) and pregnancy-induced hypertension (PIH).
- Unusually large von Willebrand factor (vWF) multimers are implicated in TTP development.
Purpose of the Study:
- To investigate factor VIII/vWF parameters in patients with PIH.
- To explore the relationship between vWF multimer changes and PIH severity.
Main Methods:
- Analyzed factor VIII/vWF parameters in 27 PIH patients and 20 healthy pregnant women.
- Utilized crossed immunoelectrophoresis and SDS-agarose gel electrophoresis for vWF analysis.
Main Results:
- Significantly higher mean vWF:Ag levels in PIH patients (358 u/dl) compared to controls (274 u/dl).
- vWF:Ag levels and vWF:Ag to factor VIII ratio correlated with PIH severity.
- Increased incidence of vWF pre-peak and higher migration index in PIH patients.
- Excessive amounts of all sizes of vWF multimers observed in PIH patients.
Conclusions:
- Quantitative changes in vWF multimers may indicate endothelial injury in PIH.
- Altered vWF multimer patterns could contribute to the microangiopathy seen in PIH.