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PFA-100 Prolonged CTs in Children

Here is a new stumper from Kim Kinney at Clarian in Indianapolis:

Hi, George. We perform many PFA-100s on both adults and children.  We have started seeing a pattern only in children.  Approximately six times in the past few months, we have seen abnormal EPI and ADP closure times with totally normal platelet aggregations.  We check all of our abnormal PFAs for platelet count, hematocrit and hemolysis.  All of these cases have had no abnormalities.  On a few cases, we have also done von Willebrand antigen, ristocetin cofactor and factor VIII levels.  All of these have been normal.  Could these be cases of mild von Willebrand disease that we cannot pick up with our traditional methods, but the PFA is picking up the abnormality?

Kim, thank you for the question, and let’s look for some answers from other PFA-100 users. Geo

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