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Laboratory misdiagnosis of von Willebrand disease in post-menarchal females: A multi-center study.
Jaffray, Julie; Staber, Janice M; Malvar, Jemily; Sidonio, Robert; Haley, Kristina M; Stillings, Amy; Weyand, Angela; Hege, Kerry; Jain, Shilpa; Gupta, Sweta; Agnew, Caroline; Wheeler, Allison; Pawar, Anjali; Sharma, Mukta; Chitlur, Meera; OʼBrien, Sarah H; Kouides, Peter.
Afiliação
  • Jaffray J; Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplant, Children's Hospital Los Angeles, Los Angeles, California, USA.
  • Staber JM; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Malvar J; Department of Pediatrics, Division of Hematology/Oncology, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA.
  • Sidonio R; Department of Pediatrics, Division of Hematology/Oncology, Carver College of Medicine, Iowa City, Iowa, USA.
  • Haley KM; Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplant, Children's Hospital Los Angeles, Los Angeles, California, USA.
  • Stillings A; Department of Pediatrics, Division of Hematology/Oncology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
  • Weyand A; Department of Pediatrics, Division of Hematology/Oncology, Emory University, Atlanta, Georgia, USA.
  • Hege K; Department of Pediatrics, Division of Hematology/Oncology, Oregon Health & Science University, Portland, Oregon, USA.
  • Jain S; Department of Pediatrics, Division of Hematology/Oncology/Bone Marrow Transplant, Children's Hospital Los Angeles, Los Angeles, California, USA.
  • Gupta S; Department of Pediatrics, Division of Hematology/Oncology, C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA.
  • Agnew C; Department of Pediatrics, Division of Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
  • Wheeler A; Department of Pediatrics, Division of Hematology/Oncology, Riley Hospital for Children at IU Health, Indianapolis, Indiana, USA.
  • Pawar A; Department of Pediatrics, Division of Hematology/Oncology, University of Buffalo, Buffalo, New York, USA.
  • Sharma M; Department of Pediatrics, Division of Hematology/Oncology, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USA.
  • Chitlur M; Department of Pediatrics, Division of Hematology/Oncology, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA.
  • OʼBrien SH; Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt University, Nashville, Tennessee, USA.
  • Kouides P; Department of Pediatrics, Division of Hematology/Oncology, University of California Davis, Davis, California, USA.
Am J Hematol ; 95(9): 1022-1029, 2020 09.
Article em En | MEDLINE | ID: mdl-32419248
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 (McNemar's 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.
Assuntos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Doenças de von Willebrand / Fator de von Willebrand / Erros de Diagnóstico Limite: Adolescent / Adult / Child / Female / Humans / Middle aged Idioma: En Revista: Am J Hematol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Doenças de von Willebrand / Fator de von Willebrand / Erros de Diagnóstico Limite: Adolescent / Adult / Child / Female / Humans / Middle aged Idioma: En Revista: Am J Hematol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos