Hematology focuses on diseases of the blood, bone marrow, and lymphatic system. Learn about the diagnosis and treatment of anemia, leukemia, and lymphoma.
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Diagnosing Von Willebrand Disease is a nuanced and often iterative process. Unlike conditions diagnosed with a single binary test, VWD requires a panel of assays interpreted in the context of the patient’s history. Levels of VWF fluctuate dynamically in response to physiological stress, inflammation, and hormones, meaning a “normal” result on one day does not definitively rule out the disease. Conversely, a “low” result does not always mean the patient has a genetic disorder. At Liv Hospital, we employ a rigorous, multi-step diagnostic algorithm adhering to international guidelines to ensure precision in diagnosis and subtyping.
The evaluation typically follows a tiered approach: screening, confirmation, and subtyping.
These initial tests evaluate the overall clotting system but are not specific for VWD.
PFA-100 (Platelet Function Analyzer): This test simulates blood flow in a vessel. It is sensitive to VWD but not specific; a normal result does not rule out mild VWD.
If screening or history is suggestive, the specific VWD panel is ordered. This triad of tests is essential.
Comparing the results of these three tests allows for initial typing.
Once a diagnosis of VWD is confirmed, sophisticated tests distinguish the specific subtype.
DNA sequencing of the VWF gene provides the ultimate confirmation.
To ensure accuracy, timing is everything.
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Aspirin affects platelet function, which can interfere with some of the functional assays used to diagnose bleeding disorders.
This is used for patients with VWF levels between 30 and 50 IU/dL. They have bleeding risk but may not have a specific genetic mutation found in classic VWD.
Not for every case, but it is very helpful for distinguishing between the complicated Type 2 subtypes and for family planning.
Basic screening takes hours, but specialized tests like Multimer Analysis or genetics can take several weeks to return from specialized laboratories.
Yes, but crying and stress during the blood draw can artificially raise levels. Sometimes testing is repeated when the child is older and calmer.
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