Potential laboratory misdiagnosis of hemophilia and von Willebrand disorder owing to cold activation of blood samples for testing.
Author(s): Favaloro EJ, Soltani S, McDonald J
Publication: Am J Clin Pathol, 2004, Vol. 122, Page 686-92
PubMed ID: 15491964 PubMed Review Paper? No
Purpose of Paper
Conclusion of Paper
Studies
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Study Purpose
The purpose of this study was to determine the effects of delayed centrifugation and storage temperature on coagulation factors, vWF:Ag, and vWF:CB in plasma specimens, which were stored at -80 degrees C until analysis. Specimens were anticoagulated with citrate.
Summary of Findings:
Storage of blood at either 4 or 22 degrees C prior to centrifugation had no effect on FII, FV, FVII, FIX, FX, FXI, or FXII compared to immediately processed specimens. However, storage of blood specimens at 4 degrees C, but not 22 degrees C, prior to centrifugation led to significantly lower test results for FVIII and vWF testing. In a clinical setting, most of these specimens would be defined as abnormal leading to a potential for misdiagnosis of hemophilia A or von Willebrand Disorder (vWD). While significant differences were observed in the levels of FVIII and vWF between O and non-O blood groups, ABO blood group had no influence on the decrease in these factors due to storage at 4 degrees C. While a minor but significant increase in plasma vWF was observed with increasing age, the decreases in vWF and FVIII after 4 degree C storage of whole blood were not influenced by age.
Biospecimens
Preservative Types
- Frozen
Diagnoses:
- Normal
Platform:
Analyte Technology Platform Protein Hematology/ auto analyzer Protein ELISA Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage temperature 4 degrees C
22 degrees C
Storage Storage duration 0 h
3.5 h
Preaquisition Patient genotype O blood group
Non-O blood group
Preaquisition Patient age Various ages
Biospecimen Aliquots and Components Centrifugation Centrifugation delays investigated