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FVIII/VWF ratio is not a reliable predictor of VWD in children

Authors

  • Brian R. Branchford MD,

    1. Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation at The Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, Colorado
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  • Katherine Ruegg MS,

    1. Hemophilia & Thrombosis Center Research Laboratory, University of Colorado, Aurora, Colorado
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  • Elizabeth Villalobos-Menuey MS,

    1. Hemophilia & Thrombosis Center Research Laboratory, University of Colorado, Aurora, Colorado
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  • Linda J. Jacobson BS,

    1. Hemophilia & Thrombosis Center Research Laboratory, University of Colorado, Aurora, Colorado
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  • Jorge A. Di Paola MD,

    1. Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation at The Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, Colorado
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  • Marilyn Manco-Johnson MD

    Corresponding author
    1. Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation at The Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, Colorado
    2. Hemophilia & Thrombosis Center Research Laboratory, University of Colorado, Aurora, Colorado
    • Correspondence to: Marilyn Manco-Johnson, Hemophilia and Thrombosis Center, University of Colorado, Children's Hospital Colorado Pediatric Hematology/Oncology/Bone Marrow Transplant, 13199 E. Montview Blvd, Suite 100, Aurora, CO 80045.

      E-mail: marilyn.manco-johnson@ucdenver.edu

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  • Conflict of interest: Nothing to declare.

Abstract

Adults with von Willebrand Disease (VWD) are known to have a ratio of factor VIII activity (FVIII:C) to von Willebrand factor antigen (VWF:Ag) greater than 1. We, however, noted healthy children with ratios that are unexpectedly high. Though the FVIII:C/VWF:Ag ratio differs significantly between healthy children and VWD patients in some age groups, the substantial overlap of observed ranges suggests that a ratio threshold-based screening approach alone cannot reliably discriminate between these groups. The diagnostic performance of this ratio is poor for VWD in children, which may decrease its value as a screening tool in the pediatric population. Pediatr Blood Cancer 2014;61:936–939. © 2013 Wiley Periodicals, Inc.

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