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Von Willebrand Panel

Does this test have other names?

von Willebrand factor antigen test, von Willebrand factor activity test, ristocetin cofactor activity test, factor VIII coagulant activity test 

What is this test?

This panel of tests is used to diagnose von Willebrand disease. This is a bleeding disorder that causes excessive bleeding from minor injuries or normal physical processes such as menstruation. It's the most common inherited bleeding disorder, but few people with the disease have symptoms.

If you have von Willebrand disease, you either don't have enough of a substance in your blood called von Willebrand factor, or your von Willebrand factor doesn't work the way it should. This substance plays several important roles in blood clotting. It helps platelets in the blood stick to each other and to the lining of your blood vessels.

This condition is inherited in three forms:

  • Type 1, in which you have too little of the von Willebrand factor

  • Type 2, in which the factor is defective

  • Type 3, in which the factor is completely missing

Sometimes people develop von Willebrand disease from health reasons, although that condition is rarer than the inherited forms. 

Why do I need this test?

You may need this test if you have symptoms of the condition:

  • Unusual bleeding from minor injuries

  • Unusual bleeding from your gums or nose

  • Bruising easily

  • In women, abnormally heavy or lengthy periods

  • Abnormal bleeding after dental or medical procedures

  • Bleeding after taking nonsteroidal anti-inflammatory medicines

You may also need this test if your healthcare provider notes that you have bleeding in your digestive tract or in your joints.

Bleeding can range from mild and occasional to life-threatening hemorrhages. 

What other tests might I have along with this test?

If your first test results are unusually low or your healthcare provider needs more information, he or she may order more specialized blood tests. These may include:

  • Von Willebrand factor multimer analysis. This test finds out if you have one of the subtypes of type 2 von Willebrand disease.

  • Ristocetin-induced platelet aggregometry. This finds out whether you have a form of type 2 disease or another disease that mimics von Willebrand disease.

  • Von Willebrand factor or factor VIII binding assay. This is another test for a form of type 2 disease. 

What do my test results mean?

Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you. 

The first lab tests to determine von Willebrand disease measure the following three substances from blood samples. Different measurements of these substances may tell which type of von Willebrand disease you have:

  • Von Willebrand factor antigen. This test measures your blood levels of von Willebrand factor.

  • Ristocetin-cofactor activity. This test measures how well your von Willebrand factor is working.

  • Factor VIII coagulant activity. Factor VIII is a protein in your blood carried by von Willebrand factor that plays a role in blood clotting. 

How is this test done?

The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand. 

Does this test pose any risks?

Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore. 

What might affect my test results?

Anxiety and stress can make your levels of von Willebrand factor and factor VIII go up. Exercising shortly before the test also can cause a rise in von Willebrand factor.

These are other things that can affect your results:

  • Difficulty drawing a blood sample

  • Certain illnesses that trigger inflammation in the body

  • Hormonal medicines, including estrogen and birth control pills

  • Pregnancy 

How do I get ready for this test?

Try to remain calm before the blood test. Tell your healthcare provider if you're pregnant, if you have any health conditions or illnesses, or if you have recently exercised. Be sure your provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use. 

Medical Reviewers:

  • Freeborn, Donna, PhD, CNM, FNP
  • Haldeman-Englert, Chad, MD