Von Willebrand Disease (VWD)
Part 2: NHLBI Diagnosis Guidelines

VWD NHLBI Guidelines (2008) Summary of Laboratory Recommendations

May 2011

Referencing VWF testing results to the population reference range, rather than to ABO-stratified reference ranges, may be clinically useful. <30 IU/dL VWF is recommended as the “cut-off” for definite VWD diagnosis (especially type 1 VWD). This recommendation does not preclude VWD diagnosis at VWF levels of 30 to 50 IU/dL, if supporting clinical history present, nor does the recommendation preclude treatment to elevate VWF if there is clinical bleeding risk. The high CV of VWD assays (VWF ristocetin cofactor, VWF antigen, factor VIII, and others), coupled with variability of VWF and factor VIII levels contributed by conditions of the patient and the plasma sample, contribute substantially to difficulties in diagnosing VWD or classifying the subtype (eg, types 1 vs. 2A, 2B, or 2M using the VWF ristocetin cofactor to antigen ratio).

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Summary of Laboratory Recommendations

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Jump to section:

• Introduction
• Objectives—Part 2
• VWD NHLBI Guidelines (2008)¹
• VWD Classification — ISTH^1,2
• VWD NHLBI Guidelines (2008) Initial Patient Evaluation — Laboratory¹
• VWD NHLBI Guidelines 2008 Initial Patient Evaluation — Laboratory¹
• VWD — Initial Laboratory Evaluation
• VWD NHLBI Guidelines (2008) Subsequent Patient Evaluation—Laboratory¹
• Additional VWD Testing — Laboratory¹
• VWF Multimer Analysis: Intermediate Resolution³
• VWF Multimer Analysis: Recommendations⁴
• VWF Multimer Analysis: Recommendations⁴
• Expected Laboratory Values in VWD¹
• Typical Patterns of Laboratory Test Results for VWD Diagnosis and Classification¹
• VWD NHLBI Guidelines (2008) "Low VWF" versus "VWD Type 1"
• VWD Diagnosis (Especially Type 1)
• VWD NHLBI Guidelines ABO Blood Group & VWF/VWD^1,5
• VWD NHLBI Guidelines ABO Blood Group and VWF/VWD: Soft Recommendations
• VWD NHLBI Guidelines (2008): Collection and Handling of Samples for Laboratory Testing¹
• VWD NHLBI Guidelines (2008): Collection and Handling of Samples for Laboratory Testing¹
• VWD NHLBI Guidelines (2008): Collection and Handling of Samples for Laboratory Testing¹
• VWD NHLBI Guidelines: Collection and Handling of Samples for Laboratory Testing^1,4
• VWD NHLBI Guidelines (2008) Summary of Laboratory Recommendations
• VWD NHLBI Guidelines (2008) Summary of Laboratory Recommendations
• References
• VWD Profile
• Questions?