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Favaloro EJ. The Role of the von Willebrand Factor Collagen-Binding Assay (VWF:CB) in the Diagnosis and Treatment of von Willebrand Disease (VWD) and Way Beyond: A Comprehensive 36-Year History. Semin Thromb Hemost 2024; 50:43-80. [PMID: 36807283 DOI: 10.1055/s-0043-1763259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The von Willebrand factor (VWF) collagen binding (VWF:CB) assay was first reported for use in von Willebrand diagnostics in 1986, by Brown and Bosak. Since then, the VWF:CB has continued to be used to help diagnose von Willebrand disease (VWD) (correctly) and also to help assign the correct subtype, as well as to assist in the monitoring of VWD therapy, especially desmopressin (DDAVP). However, it is important to recognize that the specific value of any VWF:CB is predicated on the use of an optimized VWF:CB, and that not all VWF:CB assays are so optimized. There are some good commercial assays available, but there are also some "not-so-good" commercial assays available, and these may continue to give the VWF:CB "a bad reputation." In addition to VWD diagnosis and management, the VWF:CB found purpose in a variety of other applications, from assessing ADAMTS13 activity, to investigation into acquired von Willebrand syndrome (especially as associated with use of mechanical circulatory support or cardiac assist devices), to assessment of VWF activity in disease states in where an excess of high-molecular-weight VWF may accumulate, and lead to increased (micro)thrombosis risk (e.g., coronavirus disease 2019, thrombotic thrombocytopenic purpura). The VWF:CB turns 37 in 2023. This review is a celebration of the utility of the VWF:CB over this nearly 40-year history.
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Affiliation(s)
- Emmanuel J Favaloro
- Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Sydney Centres for Thrombosis and Haemostasis, NSW Health Pathology, Westmead Hospital, Westmead, New South Wales, Australia
- School of Dentistry and Medical Sciences, Faculty of Science and Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Westmead Hospital, Westmead, New South Wales, Australia
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Owaidah T, Alharbi M, Mandourah M, Saleh M, Almusa A, Alnounou R, Alzahrani H, Khogeer H. Clinical and laboratory presentation of von Willebrand disease: Experience from a single center in KSA. J Taibah Univ Med Sci 2022; 18:413-419. [PMID: 37102076 PMCID: PMC10124135 DOI: 10.1016/j.jtumed.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives This study was aimed at assessing the clinical presentations and laboratory findings among patients diagnosed with vWD at a Saudi tertiary care unit. Methods This retrospective study included 189 patients with vWD who were followed up in our unit over 4 years. Clinical and laboratory data were collected and analyzed in SPSS. Results The median age of the study cohort was 30 years (range 11 months-56 years). The cohort had a female preponderance, with 32.30% males and 66.70% females. Bleeding from different sites was observed, mostly from the joints and muscles (23.90%), followed by the mucus membranes (14.60%), genitourinary areas (7.70%), ecchymoses (2.80%), and gastrointestinal areas (2.80%). A total of 48% of participants presented with more than one type of bleeding. A total of 105 (58.01%) participants had type 1; 29 (16.02%) had type 2; and 47 (25.96%) had type 3 vWD. Blood tests indicated the following mean value: hemoglobin, 116 ± 25.60 gm/L; ferritin, 75.80 ± 166.80 μg/L (median 28.5); vWAg, 0.40 ± 0.27IU/ml; and vWD:RCo, 0.32 ± 0.20IU/dL. The partial thromboplastin time was prolonged in 49.20% and normal in 50.80% of participants. Platelet function analysis values were prolonged in 92.90% and normal in 7.10% of participants. Comparative analysis of the O-type and non-O blood type showed that blood type O was significantly correlated with factor VIII (p-value = 0.013), vWF:RCo (p-value = 0.004), and vWF:Ag (p-value = 0.019). Conclusion Joint and muscle bleeds were the most common clinical presentations in our cohort. Although type 1 vWD was most prevalent in our cohort, we observed a comparatively higher prevalence of type 3, possibly because of ethnic differences or referral bias. We found a significant difference between O and non-O blood type regarding FVIII and vWF:Ag, and observed a more pronounced difference for vWD activity measuresd by vWF:RCo with blood type O being the systematic factor.
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Affiliation(s)
- Tarek Owaidah
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA
- Department of Haematology and Transfusion Medicine, Alfaisal University, Riyadh, KSA
- Corresponding address: Consultant Hematology and Transfusion Medicine, Alfaisal University, Riyadh 11211, KSA.
| | - Muhammed Alharbi
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA
| | - Mohammed Mandourah
- Department of Haematology and Transfusion Medicine, Alfaisal University, Riyadh, KSA
| | - Mahasen Saleh
- Department of Paediatric Haematology Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA
| | - Abdulrahman Almusa
- Department of Paediatric Haematology Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA
| | - Randa Alnounou
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, KSA
| | - Hazza Alzahrani
- Adult Hematology/HSCT, Oncology Centre, King Faisal Specialist Hospital and Research Center Riyadh, KSA
| | - Haithm Khogeer
- Adult Hematology/HSCT, Oncology Centre, King Faisal Specialist Hospital and Research Center Riyadh, KSA
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AlSaleh KA, Al-Numair N, AlSuliman A, Zolaly M, Albanyan AM, AlOtaishan N, Abudouleh E, Bayoumy N, Tarawah A, AlZahrani F, AlAllaf F, AlMomen AK, Sajid R, Owaidah TM. Prevalence of Coagulation Factors Deficiency among Young Adults in Saudi Arabia: A National Survey. TH OPEN 2020; 4:e457-e462. [PMID: 33376945 PMCID: PMC7758154 DOI: 10.1055/s-0040-1721500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/27/2020] [Indexed: 11/05/2022] Open
Abstract
Introduction
Inherited bleeding disorders vary in prevalence due to genetic disparity and ethnicity. Little is known about the prevalence of coagulation factor deficiency and bleeding disorders in middle-eastern population.
Methods
Young Saudi adults with at least one positive bleeding symptom reported in semi-structured validated condensed MCMDM-1vWD questionnaire were tested for complete blood count, routine and special coagulation tests, serum ferritin level, and capillary zone electrophoresis. After initial testing, those with prolonged prothrombin time (PT) or activated prothrombin time (APTT) had further testing to evaluate coagulation factors level. Platelet function was tested through platelet function analyzer (PFA)-100, and multiplate aggregometer (MEA) on patients suspected of having platelet disorders.
Results
Six-hundred-forty patients (male = 347, 54.2%) were included. A possible platelet function defect was diagnosed in three patients with one matching Glanzmann's thrombasthenia trait pattern, and one that of Bernard-Soulier trait pattern. One patient was diagnosed with von Willebrand disease. Deficiencies in coagulation factor levels were revealed as F-VIII in 14 (7.4%), F-IX in 15 (7.6%), F-II in two (3.3%), F-V in 17 (26.1%), FVII in two (3.1%), and F-X in one (1.8%) of study subjects; low vWF activity (<50%) was found in 14 (8%). Abnormal values were found for various laboratory tests with prolongation of platelet function analyzer-epinephrine (PFA-EPI) in 11%, PFA-ADP or arachidonic acid in 15.2%, PT in 35.9%, and APTT in 63.7%. Five-hundred-seventy-six patients (90%) had normal results in the coagulation factor assays and were categorized as patients with bleeding of unknown cause (BUC). A diagnosis of a bleeding disorder was more frequently made in men than in women (38 vs. 26). Iron deficiency anemia was found in 18 (25%) females positively associated with F-IX deficiency (
p
-value 0.000). Male gender (73.3%,
p
= 0.007) was independently associated with the diagnosis of coagulation factor deficiency.
Conclusion
The current study reports a higher prevalence of coagulation factors deficiency in Saudi population than reported in the western population.
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Affiliation(s)
- Khalid A AlSaleh
- Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Nouf Al-Numair
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, and College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ayman AlSuliman
- Research Center, King Faisal Specialist Hospital, Alfaisal University, Riyadh, Saudi Arabia
| | - Mohammed Zolaly
- Department of Pediatric, Taibah University, Medina, Saudi Arabia
| | | | - Nouf AlOtaishan
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, and College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Esra Abudouleh
- College of Medical Applied Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nervana Bayoumy
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Tarawah
- Medina Maternity and Children Hospital, Medina, Saudi Arabia
| | - Faisal AlZahrani
- Department of Pathology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal AlAllaf
- Department of Molecular Medicine, Umm Al Qura University, Makkah, Saudi Arabia
| | - Abdul Kareem AlMomen
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Raihan Sajid
- Department of Pathology, Alfaisal University, Riyadh, Saudi Arabia
| | - Tarek M Owaidah
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Alfaisal University, Riyadh, Saudi Arabia
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Influence of ABO Blood Group on von Willebrand Factor Antigen Level in Normal Individuals: A Cross-Sectional Study from Southern India. Indian J Hematol Blood Transfus 2020; 37:505-506. [PMID: 34267476 DOI: 10.1007/s12288-020-01365-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022] Open
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