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Screening for von Willebrand Disease With a New Analyzer Using
High Shear Stress: A Study of 60 Cases
Edith Fressinaud,
Agnès Veyradier,
Florence Truchaud,
Isabelle Martin,
Catherine Boyer-Neumann,
Marc Trossaert, and
Dominique Meyer
From the Laboratoire d'Hématologie, CHU Hôtel Dieu,
Nantes; and the Laboratoire d'Hématologie, Hôpital
Antoine-Béclère, Clamart, and INSERM U.143, Hôpital
de Bicêtre, Kremlin-Bicêtre, France.
We have evaluated the performance of a new analyzer using high shear
stress, the PFA-100 (Platelet Function Analyzer, Dade International,
Massy, France), for screening of patients with von Willebrand disease
(vWD). Whole citrated blood is aspirated through a capillary to the
central aperture of a membrane coated with collagen and with a platelet
agonist (either epinephrine or adenosine diphosphate
[ADP]). The time required to obtain occlusion of the
aperture by a platelet plug is defined as the closure time (CT). We
studied 60 patients with different types of vWD and 96 normal subjects.
Fourteen subjects with hemophilia and 15 patients with a platelet
disorder were also analyzed. When omitting results from two patients
with type 2N, the 58 other patients with type 1, type 2A, type 2B, type
3, or acquired vWD all exhibited an abnormal occlusion with
collagen-ADP (sensitivity, 100%) and 56 of 58 had an abnormal CT with
collagen-epinephrine (sensitivity, 96.5%). Only two patients with mild
type 1 were not detected with collagen-epinephrine. In comparison, the
bleeding time (BT) was normal in 20 patients: 17 with type 1, two with
type 2A, and one with acquired vWD (sensitivity, 65.5%). The
specificity of the PFA-100 was over 95% with both types of cartridges.
Thus, the analyzer is well adapted to routine testing, as it has the
advantages of simplicity and ease of execution, and demonstrates a high
sensitivity, clearly superior to that of BT, for the screening of
patients with vWD.
Blood, Vol. 91 No. 4 (February 15), 1998:
pp. 1325-1331
© 1998 by The American Society of Hematology.
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