Von Willebrand Disease (VWD)
Part 2: NHLBI Diagnosis Guidelines
Laboratory Recommendations
Summary
June 2011
In summary: We think that these new VWF latex activity assay has adequate sensitivity and specificity to be used as part of an initial screening panel. It has significantly improved the precision and lower detection limit. It is more sensitive than VWF ristocetin cofactor activity assay to detect acquired VWF abnormalities due to subtle losses of the highest molecular weight multimers. We also discussed some limitations of this new assay and explained our new testing algorithm. We hope that by implementing this new VWF activity assay and VWD testing algorithm we can significantly improve the accuracy and efficiency of VWD laboratory testing.
Summary |
Jump to section:
- Introduction
- Objectives
- History of VWF Ristocetin Cofactor Activity (VWF:RCo) Assay
- Problems with VWF:RCo Assay
- Summary of External Quality Assessment of VWF:RCo
- von Willebrand Disease(VWD) Diagnostic Error Rates Due to Erroneous VWF:RCo Results5
- VWF:RCo/Ag Ratio is Insensitive for Aquired von Willebrand Abnormalities (AVWA)
- VWF:RCo is Inadequate for Detecting AVW Abnormality
- The New Automated VWF Activity by Latex-Immunoturbidity Assay (VWF:Lx)
- VWF Activity Assay by an A1 Domain Conformation-Sensitive Antibody6
- Performance Characteristics of VWF:Lx
- VWF:Lx and VWF:RCo Method Comparison
- VWF:Lx and VWF:RCo Bias Analysis
- Sample Categorization
- Comparison of VWF:Lx/Ag and VWF:RCo/Ag Ratios
- VWF:Lx and VWF:RCo Errors
- Severe Type 1 vs 2M7
- VWF:Lx and RCo Errors
- VWF:Lx/Ag is Sensitive to AVWA with Subtle Loss of Highest HMWM
- ROC Analysis of VWF:Lx/Ag and VWF:RCo/Ag for Detecting AVWA with Loss of HMWMs
- VWF:Lx/Ag vs VWF:RCo/Ag Ratios
- VWF Laboratory Testing Strategy
- Sensitivity and Specificity of the Screening Panel
- von Willebrand Disease Profile
- von Willebrand Disease Profile
- von Willebrand Disease Profile
- von Willebrand Disease Profile
- Limitations of VWF:Lx
- Summary
- References
- Questions?
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