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Bleeding Disorders Association Diagnostic Tests If you have some or all of the symptoms associated with a bleeding disorder, discuss the possibility with your physician. There are specific tests that must be ordered by a physician in order to determine whether or not you have a bleeding disorder. If you have reason to be very concerned about this, you can ask your physician for a referral to a hematologist. (A hematologist is a physician who specializes in blood disorders and would be more familiar with the signs and symptoms, diagnosis, and management of bleeding disorders.) Your family's medical history (pertaining to bleeding tendencies) is also extremely important in assisting your physician in making a diagnosis. Von Willebrand disease (vWD) is frequently underdiagnosed and both the primary and secondary tests described below are needed to make an accurate diagnosis. Be aware that hormone levels in female teens and young women, pregnancy and birth control pills may increase the amount of circulating von Willebrand factor antigen, masking the disorder. It may be necessary to be evaluated several times before being diagnosed with von Willebrand disease. In general, the primary screening tests used to rule out other bleeding disorders include a complete blood count (CBC), platelet count, bleeding time (BT), prothrombin time (PT), and partial thromboplastin time (PTT). (The platelet count, BT, PT and PTT are frequently normal in individuals with vWD, but many women with vWD are chronically anemic.) Secondary screening tests that are specific for detecting vWD include von Willebrand factor antigen (VWF:Ag), ristocetin cofactor (RCo) or vWF activity, and factor VIII activity (FVIII:C). Von Willebrand factor multimer analysis and ristocetin induced platelet aggregation (RIPA) are helpful in distinguishing Type 2 vWD and its subtypes. The patient's blood type should also be determined because individuals with type O blood have naturally lower levels of vWF than people with other blood types. | |||
