ABSTRACT
The diagnostic tests for vWD consist of an in vivo assessment of primary hemostasis, the bleeding time, and in vitro tests designed to assess the vWf on both a quantitative and qualitative basis. In this chapter, the authors attempt to briefly but critically review the methods currently available for the diagnosis and evaluation of vWD. The observation that the bleeding time is principally dependent upon the concentration of platelet vWf rather than plasma levels of vWf, which hitherto have been primarily used to establish the diagnosis, may explain this overlap, particularly since platelet vWf concentrations in mild type I vWD are frequently normal. Howard and Firkin reported that ristocetin induced platelet aggregation in PRP in normal individuals but not vWD patients. The authors have, therefore, indicated that this assay could be used as a substitute for the ristocetin co-factor method in the laboratory evaluation of vWD.
