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The effect of ABO blood group on the diagnosis of von Willebrand disease
JC Gill, J Endres-Brooks, PJ Bauer, WJ Marks and RR Montgomery
In order to firmly establish a normal range for von Willebrand factor
antigen (vWF:Ag), we determined plasma vWF:Ag concentrations in 1,117
volunteer blood donors by quantitative immunoelectrophoresis. The presence
of the ABO blood group has a significant influence on vWF:Ag values;
individuals with blood group O had the lowest mean vWF:Ag level (74.8
U/dL), followed by group A (105.9 U/dL), then group B (116.9 U/dL), and
finally group AB (123.3 U/dL). Multiple regression analysis revealed that
age significantly correlated with vWF:Ag levels in each blood group. We
then performed reverse ABO typing on stored plasma from 142 patients with
the diagnosis of von Willebrand disease (vWd). Of 114 patients with type I
vWd, blood group O was found in 88 (77%), group A in 21 (18%), group B in 5
(4%), and group AB in none (0%), whereas the frequency of these blood
groups in the normal population is significantly different (45%, 45%, 7%
and 3%, respectively) (P less than .001). Patients with type II or III vWd
had ABO blood group frequencies that were not different from the expected
distribution. There may be a subset of symptomatic vWd patients with
decreased concentrations of structurally normal vWf (vWd, type I) on the
basis of blood group O. Some individuals of blood group AB with a genetic
defect of vWF may have the diagnosis overlooked because vWF levels are
elevated due to blood type.
Volume 69,
Issue 6,
pp. 1691-1695,
06/01/1987
Copyright © 1987 by The American Society of Hematology
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