Journal article
Laboratory misdiagnosis of von Willebrand disease in post‐menarchal females: A multi‐center study
American journal of hematology, Vol.95(9), pp.1022-1029
09/2020
DOI: 10.1002/ajh.25869
PMID: 32419248
Abstract
Increased awareness of von Willebrand Disease (VWD) has led to more frequent diagnostic laboratory testing, which insurers often dictate be performed at a facility with off‐site laboratory processing, instead of a coagulation facility with onsite processing. Off‐site processing is more prone to preanalytical variables causing falsely low levels of von Willebrand Factor (VWF) due to the additional transport required. Our aim was to determine the percentage of discordance between off‐site and onsite specimen processing for VWD in this multicenter, retrospective study. We enrolled females aged 12 to 50 years who had off‐site specimen processing for VWF assays, and repeat testing performed at a consulting institution with onsite coagulation phlebotomy and processing. A total of 263 females from 17 institutions were included in the analysis. There were 251 subjects with both off‐site and onsite VWF antigen (VWF:Ag) processing with 96 (38%) being low off‐site and 56 (22%) low onsite; 223 subjects had VWF ristocetin co‐factor (VWF:RCo), 122 (55%) were low off‐site and 71 (32%) were low onsite. Similarly, 229 subjects had a Factor VIII (FVIII) assay, and 67 (29%) were low off‐site with less than half, 29 (13%) confirmed low with onsite processing. Higher proportions of patients demonstrated low VWF:Ag, VWF:RCo, and/or FVIII with off‐site processing compared to onsite (McNemarʼs test P‐value <.0005, for all assays). These results emphasize the need to decrease delays from sample procurement to processing for VWF assays. The VWF assays should ideally be collected and processed at the same site under the guidance of a hematologist.
Details
- Title: Subtitle
- Laboratory misdiagnosis of von Willebrand disease in post‐menarchal females: A multi‐center study
- Creators
- Julie Jaffray - University of Southern CaliforniaJanice M Staber - Carver College of MedicineJemily Malvar - Childrenʼs Hospital Los AngelesRobert Sidonio - Emory UniversityKristina M Haley - Oregon Health & Science UniversityAmy Stillings - Childrenʼs Hospital Los AngelesAngela Weyand - University of MichiganKerry Hege - Riley Hospital for Children at IU HealthShilpa Jain - University of BuffaloSweta Gupta - Indiana Hemophilia and Thrombosis CenterCaroline Agnew - St. Christopherʼs Hospital for ChildrenAllison Wheeler - Vanderbilt UniversityAnjali Pawar - University of California DavisMukta Sharma - University of Missouri Kansas CityMeera Chitlur - Childrenʼs Hospital of MichiganSarah H OʼBrien - The Ohio State University College of MedicinePeter Kouides - University of Rochester
- Resource Type
- Journal article
- Publication Details
- American journal of hematology, Vol.95(9), pp.1022-1029
- DOI
- 10.1002/ajh.25869
- PMID
- 32419248
- NLM abbreviation
- Am J Hematol
- ISSN
- 0361-8609
- eISSN
- 1096-8652
- Publisher
- John Wiley & Sons, Inc; Hoboken, USA
- Number of pages
- 8
- Language
- English
- Date published
- 09/2020
- Academic Unit
- Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Hematology/Oncology
- Record Identifier
- 9984070834402771
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