{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:01:04Z","timestamp":1750204864966,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,7,27]],"date-time":"2017-07-27T00:00:00Z","timestamp":1501113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>von Willebrand disease (VWD) reflects a loss or dysfunction in von Willebrand factor (VWF), while haemophilia represents a loss or dysfunction of clotting factors such as factor VIII (FVIII) or FIX. Their diagnosis requires laboratory testing, with this potentially compromised by preanalytical events, including poor sample quality. This study assessed the effect of inadequate mixing as a potential cause of VWD and haemophilia misdiagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After completion of requested testing, 48 consecutive patient samples comprising separate aliquots from single collections were individually pooled, appropriately mixed, then frozen in separate aliquots, either at \u221220\u00b0C or \u221280\u00b0C for 2\u20107\u00a0days. Each sample set was then thawed and the separate aliquots subjected to separate mixing protocols (several inversions, blood roller, vortex) vs a non\u2010mix sample, and all aliquots then tested for various <jats:styled-content style=\"fixed-case\">VWF<\/jats:styled-content> and factor assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Non\u2010mixing led to substantial reduction in <jats:styled-content style=\"fixed-case\">VWF<\/jats:styled-content> and factors in about 25% of samples, that in some cases could lead to misdiagnosis of <jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content> or haemophilia. Interestingly, there were also some differences observed with respect to different mixing protocols.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study identified ineffective or variable mixing of thawed plasma samples as potential causes of misdiagnosis of <jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content> or haemophilia. Further education regarding the importance of appropriate mixing appears warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hae.13305","type":"journal-article","created":{"date-parts":[[2017,7,27]],"date-time":"2017-07-27T23:38:41Z","timestamp":1501198721000},"source":"Crossref","is-referenced-by-count":13,"title":["Potential misdiagnosis of von Willebrand disease and haemophilia caused by ineffective mixing of thawed plasma"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2103-1661","authenticated-orcid":false,"given":"E. J.","family":"Favaloro","sequence":"first","affiliation":[{"name":"Department of Haematology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead Hospital  Westmead NSW Australia"},{"name":"Sydney Centres for Thrombosis and Haemostasis Westmead Hospital  Westmead NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Oliver","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead Hospital  Westmead NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead Hospital  Westmead NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead Hospital  Westmead NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Grzechnik","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead Hospital  Westmead NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Azimulla","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead Hospital  Westmead NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Haematology Institute of Clinical Pathology and Medical Research NSW Health Pathology Westmead Hospital  Westmead NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Lima\u2010Oliveira","sequence":"additional","affiliation":[{"name":"Section of Clinical Biochemistry University of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Lippi","sequence":"additional","affiliation":[{"name":"Section of Clinical Biochemistry University of Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1281028"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1334867"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1564800"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2016.03.001"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1581127"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1598058"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1309\/LM749BQETKYPYPVM"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2017.1295317"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1315961"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1319768"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1544196"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2016.10.009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2015.12.010"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2014.09.024"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13064"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13261"},{"volume-title":"Collection, Transport, and Processing of Blood Specimens for Testing Plasma\u2010Based Coagulation assays and Molecular Hemostasis Assays; Approved Guideleine","year":"2008","author":"CLSI","key":"e_1_2_8_18_1"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.24556"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2012.04729.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2014.05.020"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000000326"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000000429"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhae.13305","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.13305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T14:03:03Z","timestamp":1695564183000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.13305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,27]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1111\/hae.13305"],"URL":"https:\/\/doi.org\/10.1111\/hae.13305","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"type":"print","value":"1351-8216"},{"type":"electronic","value":"1365-2516"}],"subject":[],"published":{"date-parts":[[2017,7,27]]}}}