Comparison of PFA-100 and bleeding time testing in pediatric patients with suspected hemorrhagic problems.
BACKGROUND
The bleeding time test is difficult to perform, standardize, and interpret in children. In this study the authors evaluated the sensitivity, specificity, and efficiency of the bleeding time test and the PFA-100 in a series of children referred for possible bleeding problems.


METHODS
Between February 2000 and August 2001 patients aged more than 6 months and less than 18 years of age who were referred to the authors' institution for a hemostatic evaluation were included in the study if residual blood was available for testing on the PFA-100 instrument. Fifty-two children had platelet count, prothrombin time, partial thromboplastin time, bleeding time, and PFA-100 testing performed as well as an evaluation by a hematologist. For PFA-100 testing, 52 patients had Col/Epi measurements; adequate sample remained for Col/ADP testing on 32. Additional testing for diagnostic purposes was at the discretion of the treating physician.


RESULTS
Use of the Col/Epi cartridge in the PFA-100 instrument offered 100% sensitivity and 97% specificity for detection of qualitative platelet abnormalities, compared with 37% and 88%, respectively, for bleeding time testing. For pediatric patients with von Willebrand disease, the sensitivity was 100% using the Col/Epi cartridge, compared with 17% for the bleeding time test. The sensitivities for combined qualitative platelet defects and von Willebrand disease using the Col/Epi or Col/ADP cartridges were 100% and 87%, respectively, compared with 37% for the bleeding time test.


CONCLUSIONS
The PFA-100 is a more efficient test; it can replace the bleeding time test as a component of the laboratory evaluation of children with a potential bleeding problem.
Cariappa
Rohit
R
Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Wilhite
Timothy R
TR
Parvin
Curtis A
CA
Luchtman-Jones
Lori
L
D000293:Adolescent; D001760:Bleeding Time; D001792:Blood Platelets / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D005260:Female; D006400:Hematocrit; D006801:Humans; D007223:Infant; D008297:Male; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D010979:Platelet Function Tests / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012680:Sensitivity and Specificity; D014842:von Willebrand Diseases / Q000175:diagnosis* / Q000188:drug therapy
D003894:Deamino Arginine Vasopressin