Establishing reference intervals for von Willebrand factor multimers

  • Marika Pikta Department of Laboratory Medicine, North Estonia Medical Centre, Tallinn, Estonia https://orcid.org/0000-0002-5891-7589
  • Marc Vasse Department of Biology & UMR INSERM 1176, Foch Hospital, Suresnes, France
  • Kristi J. Smock Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
  • Karen Moser Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
  • Marie-Astrid van Dievoet Laboratory department, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
  • Sandra Lejniece Riga Stradins University, Riga, Latvia
  • Timea Szanto Coagulation Disorders Unit, Department of Hematology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
  • Hector Bautista Sebia, Research and Developments Department, Parc Technologique Léonard de Vinci, CP 8010 Lisses - 91008 Evry Cedex, France
  • George Nouadje Sebia, Research and Developments Department, Parc Technologique Léonard de Vinci, CP 8010 Lisses - 91008 Evry Cedex, France
  • Valdas Banys Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
DOI: https://doi.org/10.5937/jomb0-31941
Keywords: von Willebrand factor, von Willebrand factor multimers, quantitative analysis, reference intervals

Abstract


Background: von Willebrand factor (VWF) multimers (VWF:MM) methodologies are technically difficult, laborious, time consuming, non-standardized and results vary between laboratories. A new semi‐automated VWF:MM assay is available for routine use (Sebia). Due to lack of reference values for VWF:MM fractions, results interpretation can be challenging in some cases.

Aims: The aim of this study was to determine reference intervals for low molecular weight (LMWM), intermediate molecular weight (IMWM) and high molecular weight (HMWM) multimers.

Methods: Samples of 134 healthy individuals were analyzed. Acceptance criteria: no history of hemorrhagic episodes; no usage of any interfering medication for at least 10 days before blood collection; normal coagulation screening tests; normal VWF screening assay results; written consent provided.

Results: After outlier exclusion (n=3), done by Grubs double sided and Tukey methods, a total of 131 samples were analyzed statistically. The proposed reference intervals for VWF:MM were calculated for LMWM 10.4-22.5%, IMWM 22.6-37.6%, HMWM 45.6-66.6%.

Conclusions: Quantification of VWF:MM fractions, in addition to qualitative assessment of VWF:MM patterns, has the potential to aid in differential diagnosis of von Willebrand disease (VWD) subtypes. The reference values calculated in this study can be used in future research to establish clinical decision limits.

Published
2021/09/17
Issue
Vol. 41 No. 1 (2022): Journal of Medical Biochemistry
Section
Original paper

Copyright (c) 2021 Marika Pikta

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