Von Willebrand Disease (VWD)
Part 3: VWF Activity Assay

Introduction

June 2011

Welcome to Mayo Medical Laboratories' Hot Topics. These presentations provide short discussions of current topics and may be helpful to you in your practice.

Our speaker for this program is Dong Chen, MD, PhD, Co-director of the Special Coagulation Laboratory at Mayo Clinic in Rochester, Minnesota. Dr. Chen will describe the newly implemented von Willebrand factor activity assay and its use in the laboratory diagnosis of von Willebrand disease.

Thank you for tuning in for this series regarding von Willebrand Disease laboratory testing. Today, I will discuss our newly implemented automated latex particle-enhanced immunoturbidimetric von Willebrand factor activity assay, or VWF latex activity in short.

Introduction

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• 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?