[Is the DDAVP-test helpful to diagnose children?].
It is very difficult to determine if patients with a moderate low level of VWF parameters have mild disease or if they are just low normal (so called grey area of VWD). This applies particularly to pediatrics, because it is difficult to evaluate the bleeding history of children. Al our centres every child diagnosed with vWD gets DDAVP to test the response for it. This study was done to evaluate the DDAVP- test as a diagnostic tool.


METHODS
A retrospective analysis of data obtained with routine DDAVP administration for test purposes in 52 patients with borderline von Willebrand disease at the haemophilia centre Graz was done. The increase of VWF:Ag, VWF:RiCof and FVIII:C has been document and compared.


RESULTS
All of our patients had a very good response after application of DDAVP. The increase of VWF:Ag, VWF:RiCof and FVIII:C was compared in patients with positive and negative bleeding anamneses. The patients with positive anamneses had significantly lower parameters at the beginning. The increase of VWF parameters did not differ significantly between the groups at the different time-points. These results demonstrate that a positive anamnesis is not significantly associated with a lower increase. On the other side a high increase is not associated with a negative anamnesis.


CONCLUSIONS
It is not possible to use the DDAVP test as a diagnostic tool for patients within the diagnostic grey area of VWD.
Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria. wolfgang.muntean@meduni-graz.at
E
E
Weissenbacher
B
B
Acham-Roschitz
B
B
Leschnik
W
W
Muntean
D003894:Deamino Arginine Vasopressin / Q000032:analysis*; D005169:Factor VIII / Q000378:metabolism; D006467:Hemophilia A / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014842:von Willebrand Diseases / Q000097:blood / Q000175:diagnosis*; D014841:von Willebrand Factor / Q000378:metabolism
D014841:von Willebrand Factor; D005169:Factor VIII; D003894:Deamino Arginine Vasopressin