title: The type of factor VIII deficient plasma used influences the performance of the Nijmegen modification of the Bethesda assay for factor VIII inhibitors.
abstract: We have investigated the influence of the type of factor VIII deficient plasma used on the assay results of the Nijmegen modification of the Bethesda method for factor VIII inhibitors. Immuno depleted factor VIII deficient plasmas, lacking besides factor VIII also von Willebrand factor, gave decreased inhibitor titres compared to assay results with factor VIII deficient plasmas containing von Willebrand factor suggesting the need of the latter in the test system for the stability of factor VIII:C. Moreover the performance of the assay with immuno depleted plasma was contaminated in a certain type of this plasma by the presence of a factor VIII:C inhibitor. Chemically depleted factor VIII deficient plasma appeared to give falsely elevated titres when used in combination with other types of deficient plasmas as substrate plasma in the factor VIII:C assay due to the presence of activated factor Va in the preparation. Suggestions are described with respect to the observed limitations in order to obtain reliable results.
authors.affiliation: Central Laboratory for Haematology, University Medical Centre St Radboud, Nijmegen, The Netherlands. H.Verbruggen@chl.azn.nl
authors.forename: B
authors.initials: B
authors.lastname: Verbruggen
authors.forename: A
authors.initials: A
authors.lastname: Giles
authors.forename: J
authors.initials: J
authors.lastname: Samis
authors.forename: K
authors.initials: K
authors.lastname: Verbeek
authors.forename: E
authors.initials: E
authors.lastname: Mensink
authors.forename: I
authors.initials: I
authors.lastname: Novákovà
mesh_terms: D001780:Blood Coagulation Tests / Q000592:standards*; D002021:Buffers; D005169:Factor VIII / Q000037:antagonists & inhibitors*; D015943:Factor Va / Q000032:analysis; D005189:False Positive Reactions; D006467:Hemophilia A / Q000097:blood*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007093:Imidazoles / Q000494:pharmacology; D007074:Immunoglobulin G / Q000276:immunology; D007518:Isoantibodies / Q000097:blood*; D015203:Reproducibility of Results; D014842:von Willebrand Diseases / Q000097:blood; D014841:von Willebrand Factor / Q000032:analysis / Q000494:pharmacology
chemical_list: D002021:Buffers; D007093:Imidazoles; D007074:Immunoglobulin G; D007518:Isoantibodies; D014841:von Willebrand Factor; D015943:Factor Va; C029899:imidazole; D005169:Factor VIII