Risk of excessive bleeding associated with marginally low von Willebrand factor and mild platelet dysfunction

2.50
Hdl Handle:
http://hdl.handle.net/2336/6339
Title:
Risk of excessive bleeding associated with marginally low von Willebrand factor and mild platelet dysfunction
Authors:
Gudmundsdottir, B R; Marder, V J; Onundarson, P T
Citation:
J Thromb Haemost. 2007:5(2):274-81
Issue Date:
5-Feb-2007
Abstract:
Background: Bleeding symptoms are so commonly reported that it is not known whether they associate causally or coincidentally with mild but measureable primary hemostatic defects. Objectives/Patients/Methods: In order to evaluate if the mild primary hemostatic defects are truly causative of increased bleeding symptoms, we surveyed a population of healthy teenagers for bleeding symptoms. Using a case-control approach, we then estimated the risk of excessive bleeding associated with low von Willebrand factor (defined as VWF below the 5th percentile of a normal reference population) or mild platelet dysfunction (PD, defined as concurrent reduced platelet aggregation responses to two agonists (ADP and epinephrine). Results: Excessive bleeding was present in 63 out of 809 teenagers (7.8%). Among the 49 cases who were tested for VWF, low values by three measures was more commonly present than in 166 controls, specifically, ristocetin cofactor activity (20.4% vs 5.4%, odds ratio 4.5), collagen binding (14.3% vs 4.2%, OR 3.8), and antigen level (20.4% vs 6.0%, OR 4.0). The low ristocetin cofactor values ranged from 35-45 U/dL except for a single case with 26 U/dL. Of the 47 teenagers with excessive bleeding who underwent platelet aggregation studies, reduced responses were more common than in controls (12.8% vs 4.4%, OR 3.2). Twenty nine percent of cases with excessive bleeding had either low ristocetin cofactor or PD. Conclusions: Almost one in three teenagers who report excessive bleeding are likely to have a measurable hemostatic disturbance manifested either by marginally low VWF (by three measures) or mild PD.
Description:
To access Publisher full text version of this article. Please click on the hyperlink in Additional Link
Additional Links:
http://onlinelibrary.wiley.com/doi/10.1111/j.1538-7836.2007.02326.x/abstract

Full metadata record

DC FieldValue Language
dc.contributor.authorGudmundsdottir, B R-
dc.contributor.authorMarder, V J-
dc.contributor.authorOnundarson, P T-
dc.date.accessioned2006-12-04T09:22:55Z-
dc.date.available2006-12-04T09:22:55Z-
dc.date.issued2007-02-05-
dc.date.submitted2007-12-04-
dc.identifier.citationJ Thromb Haemost. 2007:5(2):274-81en
dc.identifier.issn1538-7933-
dc.identifier.pmid17137472-
dc.identifier.doi10.1111/j.1538-7836.2006.02326.x-
dc.identifier.otherHEM12-
dc.identifier.urihttp://hdl.handle.net/2336/6339-
dc.descriptionTo access Publisher full text version of this article. Please click on the hyperlink in Additional Linken
dc.description.abstractBackground: Bleeding symptoms are so commonly reported that it is not known whether they associate causally or coincidentally with mild but measureable primary hemostatic defects. Objectives/Patients/Methods: In order to evaluate if the mild primary hemostatic defects are truly causative of increased bleeding symptoms, we surveyed a population of healthy teenagers for bleeding symptoms. Using a case-control approach, we then estimated the risk of excessive bleeding associated with low von Willebrand factor (defined as VWF below the 5th percentile of a normal reference population) or mild platelet dysfunction (PD, defined as concurrent reduced platelet aggregation responses to two agonists (ADP and epinephrine). Results: Excessive bleeding was present in 63 out of 809 teenagers (7.8%). Among the 49 cases who were tested for VWF, low values by three measures was more commonly present than in 166 controls, specifically, ristocetin cofactor activity (20.4% vs 5.4%, odds ratio 4.5), collagen binding (14.3% vs 4.2%, OR 3.8), and antigen level (20.4% vs 6.0%, OR 4.0). The low ristocetin cofactor values ranged from 35-45 U/dL except for a single case with 26 U/dL. Of the 47 teenagers with excessive bleeding who underwent platelet aggregation studies, reduced responses were more common than in controls (12.8% vs 4.4%, OR 3.2). Twenty nine percent of cases with excessive bleeding had either low ristocetin cofactor or PD. Conclusions: Almost one in three teenagers who report excessive bleeding are likely to have a measurable hemostatic disturbance manifested either by marginally low VWF (by three measures) or mild PD.en
dc.language.isoenen
dc.publisherBlackwell Pub.en
dc.relation.urlhttp://onlinelibrary.wiley.com/doi/10.1111/j.1538-7836.2007.02326.x/abstracten
dc.subject.meshvon Willebrand Factoren
dc.subject.meshBlood Platelet Disordersen
dc.subject.meshBleeding Timeen
dc.subject.meshBlood Platelet Disordersen
dc.subject.meshPlatelet Function Testsen
dc.titleRisk of excessive bleeding associated with marginally low von Willebrand factor and mild platelet dysfunctionen
dc.typeArticleen
dc.identifier.journalJournal of thrombosis and haemostasis : JTHen
dc.format.digYES-

Related articles on PubMed

All Items in Hirsla are protected by copyright, with all rights reserved, unless otherwise indicated.