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von Willebrand Antigen

Specimen Required

Sodium Citrate (PT Vial)

Fasting Required

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Purpose of the Test

To help determine the cause of unexplained excessive or repeated episodes of bleeding, to diagnose von Willebrand disease (VWD), and to distinguish between different types of VWD

When this test is required

VWF testing is requested after initial screening tests for a bleeding disorder (such as platelet function tests, PT, PTT) have been performed to investigate someone’s personal or family history of excessive or recurrent bleeding episodes. The signs and symptoms that may prompt testing vary depending on the type of VWD an individual has and may include: Frequent or repeated nose bleeds Excessive bleeding from the gums after dental procedures Excessive bruising after minor knocks or injuries Heavy and/or prolonged menstrual bleeding in women Blood in urine or stool Prolonged bleeding after surgeryVWF tests may be repeated when they are initially normal but suspicions of VWD remain high.When VWF testing suggests VWD, additional testing may be performed to determine which subtype the person has.

What the Test Detects

Von Willebrand factor (vWF or VWF) is a protein that is one of several components of the coagulation system that work together, and in sequence, to stop bleeding within the body. VWF testing measures the amount of the protein present in blood and determines how well the protein functions. Normally, when a blood vessel is damaged and bleeding begins, VWF forms an adhesive bridge between activated cell fragments called platelets and…Von Willebrand factor (vWF or VWF) is a protein that is one of several components of the coagulation system that work together, and in sequence, to stop bleeding within the body. VWF testing measures the amount of the protein present in blood and determines how well the protein functions. Normally, when a blood vessel is damaged and bleeding begins, VWF forms an adhesive bridge between activated cell fragments called platelets and the injury site. This is followed by the clumping (aggregation) of platelets at the site and a series of actions referred to as activation of the coagulation cascade, resulting in the formation of a stable blood clot. VWF further affects clotting by influencing the availability of coagulation factor VIII. VWF carries factor VIII in the blood, increases its half-life, and releases it as necessary. If the amount of functional VWF is insufficient, then platelet adherence and aggregation are affected, levels of factor VIII could be decreased, blood clot formation takes longer, and therefore bleeding is prolonged. This deficiency causes a condition referred to as von Willebrand disease (VWD). VWD is the most common inherited bleeding disorder. It is a group of conditions associated with prolonged bleeding due to deficient and/or defective VWF. VWD is separated into different types and sub-types, including:Type 1 – with this type of VWD, there is a decrease in the amount of VWF produced, but the VWF functions normally. Levels of factor VIII are also typically low but may be normal. This is the most common type of VWD, accounting for about 75% of cases. It tends to cause bruising and mild to moderate bleeding, such as persistent nosebleeds, heavy menstrual periods, and prolonged bleeding following childbirth, trauma, dental procedures, and surgeries. Symptoms and the severity of bleeding will vary from person to person and from episode to episode. Type 2 – this type is associated with a normal amount of VWF, but the VWF does not function normally. Bleeding may be more severe with this with this type. Type 2 is further divided into Types 2A, 2B, 2M, and 2N. Type 3 – this rare type is associated with very little VWF production, very low factor VIII levels, and moderate to severe symptoms. It is often detected in infancy because of early bleeding episodes. Rarely, VWD may be due to an acquired VWF deficiency, where there is no family or personal bleeding history up to the point when signs and symptoms develop. (For more on this, see Common Questions #7.) Von Willebrand factor testing includes VWF antigen, which measures the amount of VWF, and VWF activity (also known as Ristocetin Cofactor), which evaluates the function of VWF. Some laboratories may offer a panel that includes both of these tests along with a factor VIII activity test.  How is the sample collected for testing? A blood sample is obtained by inserting a needle into a vein in the arm. Is any test preparation needed to ensure the quality of the sample? No test preparation is needed. See MoreSee Less

Preparation for the Test

None

Sample Requirements

A blood sample taken from a vein in your arm

Additional Notes

A person’s ABO blood type affects VWF concentrations. People with type O blood have VWF levels that are up to 25% lower than those with other blood types.Measuring concentrations of other acute phase reactants such as CRP and fibrinogen may be helpful if VWF concentrations are borderline normal. For example, a borderline normal VWF with significantly high CRP and/or fibrinogen may suggest VWD.VWF is produced by megakaryocytes and by the endothelial cells that line blood vessels. It is released by platelets and endothelial cells as needed.