Sources of variation in factor VIII, von Willebrand factor and fibrinogen measurements: implications for detecting deficiencies and increased plasma levels

Thrombosis Research
Juergen BachPeter Hellstern

Abstract

Differences in pre-analytical and assay conditions, inappropriate reference ranges, or inflammation may have the potential to impair clinical decisions based on measurements of factor VIII (FVIII), von Willebrand factor (VWF) and fibrinogen (Fg). This study examined the impact on FVIII, VWF and Fg in plasma of freezing and thawing, different citrate anticoagulant concentrations, and inflammation, as determined by high-sensitivity C-reactive protein (hsCRP). FVIII was determined prior to freezing and after thawing using a one-stage clotting assay (FVIII:C), an amidolytic assay (FVIII:AM) and an enzyme immunoassay (FVIII:Ag). Samples were anticoagulated with 106 or 129 mmol/L of citrate. FVIII, VWF and Fg were quantified in 300 individuals to establish reference ranges and to investigate associations with hsCRP. Freezing and thawing reduced FVIII:C and FVIII:AM markedly. FVIII coagulant activities were not significantly different between samples anticoagulated with 106 or 129 mmol/L of citrate, respectively. FVIII, VWF and Fg were significantly associated with hsCRP. FVIII:C was greater than FVIII:AM and FVIII:Ag in all experiments, indicating that the presence of activated FVIII may lead to overestimation of FVIII:C. Standardize...Continue Reading

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Citations

Feb 14, 2013·Blood Cells, Molecules & Diseases·Wei ShenChunmei Ying
May 18, 2012·Transfusion·Richard John Benjamin, Lisa Swinton McLaughlin
Aug 25, 2015·Mechanisms of Ageing and Development·Cesar SepúlvedaEduardo Fuentes
Feb 18, 2016·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Azra Riaz, Rafeeq A Khan

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