Von Willebrand disease screening: Difference between revisions

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{{Von Willebrand disease}}
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{{Von Willebrand disease}}
{{Von Willebrand disease}}


{{CMG}}
{{CMG}}  {{AE}} {{PTD}}


==Overview==
==Overview==
The ISTH-Bleeding Assessment Tool is a validated instrument that is used to screen patients referred for bleeding symptoms for further laboratory testing. The three main screening tests used in the diagnosis of VWD include vonWillebrand Factor (VWF) antigen, platelet-dependent VWF activity, and factor VIII activity.
.


==Screening==
==Screening==
The ISTH-Bleeding Assessment Tool is a validated instrument that is used to screen patients referred for bleeding symptoms for further laboratory testing.<ref name="pmid30064913">{{cite journal |vauthors=Rao ES, Ng CJ |title=Current approaches to diagnostic testing in von Willebrand Disease |journal=Transfus. Apher. Sci. |volume= |issue= |pages= |date=July 2018 |pmid=30064913 |doi=10.1016/j.transci.2018.07.005 |url=}}</ref>


Scoring key for the Pediatric Bleeding Questionnaire used in screening Von willebrand disease<ref name="pmid25982122">{{cite journal |vauthors=Mittal N, Naridze R, James P, Shott S, Valentino LA |title=Utility of a Paediatric Bleeding Questionnaire as a screening tool for von Willebrand disease in apparently healthy children |journal=Haemophilia |volume=21 |issue=6 |pages=806–11 |year=2015 |pmid=25982122 |pmc=4673659 |doi=10.1111/hae.12689 |url=}}</ref>
The three main screening tests used in the diagnosis of VWD include:
{| class="wikitable"
* VonWillebrand Factor (VWF) antigen
!Symptom/score
* Platelet-dependent VWF activity
!-1
* Factor VIII activity.
!0
!1
!2
!3
!4
|-
!'''Epistaxis'''
|'''-'''
|No or trivial (≤5 per
year)
|>5 per year OR >10
minutes duration
|Consultation only
|Packing, cauterization or
antifibrinolytics
|Blood transfusion, replacement
therapy or desmopressin
|-
!'''Cutaneous'''
|'''-'''
|No or trivial (≤1cm)
|>1cm AND no trauma
|Consultation only
| -
| -
|-
!'''Minor wounds'''
|'''-'''
|No or trivial (≤5 per
year)
|>5 per year OR >5
minutes duration
|Consultation only or Steristrips
|Surgical hemostasis or
antifibrinolytics
|Blood transfusion, replacement
therapy or desmopressin
|-
!'''Oral cavity'''
|'''-'''
|No
|Reported at least once
|Consultation only
|Surgical hemostasis or
antifibrinolytics
|Blood transfusion, replacement
therapy or desmopressin
|-
!'''Gastrointestinal'''
'''tract'''
|'''-'''
|No
|Identified cause
|Consultation or spontaneous
|Surgical hemostasis,
antifibrinolytics, blood
 
transfusion, replacement therapy
 
or desmopressin
| -
|-
!'''Tooth extraction'''
|No bleeding in at least
2 extractions
|None done or no
bleeding in 1
 
extraction
|Reported, no
consultation
|Consultation only
|Resuturing, repacking or
antifibrinolytic
|Blood transfusion, replacement
therapy or desmopressin
|-
!'''Surgery'''
|No bleeding in at least
2 surgeries
|None done or no
bleeding in 1
|Reported, no
consultation
|Consultation only
|Surgical hemostasis or
antifibrinolytics
|Blood transfusion, replacement
therapy or desmopressin
|-
!'''Menorrhagia'''
| -
|No
|Reported or consultation
only
|Antifibrinolytics or
contraceptive pill use
|D&C or iron therapy
|Blood transfusion, replacement
therapy or desmopressin
|-
!'''Post-partum'''
|No bleeding in at least
2 deliveries
|No deliveries or no
bleeding in 1 delivery
|Reported or consultation
only
|D&C, iron therapy or
antifibrinolytics
|Blood transfusion, replacement
therapy or desmopressin
| -
|-
!'''Muscle hematoma'''
| -
|Never
|Post-trauma, no therapy
|Spontaneous, no therapy
|Spontaneous or traumatic,
requiring replacement therapy or
 
desmopressin
|Spontaneous or traumatic,
requiring surgical intervention
 
or blood transfusion
|-
!'''Hemarthrosis'''
|                  -
|Never
|Post-trauma, no therapy
|Spontaneous, no therapy
|Spontaneous or traumatic,
requiring replacement therapy or
 
desmopressin
|Spontaneous or traumatic,
requiring surgical intervention
 
or blood transfusion
|-
!'''Central nervous'''
'''system'''
|                  -
|Never
| -
| -
|Subdural, any intervention
|Intracerebral, any intervention
|-
!'''Other'''
'''(eg. umbilical stump bleeding,'''
 
'''cephalhematoma,'''
 
'''post-circumcision bleeding, post-venipuncture bleeding,'''
 
'''and macroscopic hematuria)'''
|                -
|No
|Reported
|Consultation only
|Surgical hemostasis,
antifibrinolytics or iron therapy
|Blood transfusion, replacement
therapy or desmopressin
|}


==References==
==References==

Latest revision as of 14:47, 30 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Overview

The ISTH-Bleeding Assessment Tool is a validated instrument that is used to screen patients referred for bleeding symptoms for further laboratory testing. The three main screening tests used in the diagnosis of VWD include vonWillebrand Factor (VWF) antigen, platelet-dependent VWF activity, and factor VIII activity.

.

Screening

The ISTH-Bleeding Assessment Tool is a validated instrument that is used to screen patients referred for bleeding symptoms for further laboratory testing.[1]

The three main screening tests used in the diagnosis of VWD include:

  • VonWillebrand Factor (VWF) antigen
  • Platelet-dependent VWF activity
  • Factor VIII activity.

References

  1. ↑ Rao ES, Ng CJ (July 2018). "Current approaches to diagnostic testing in von Willebrand Disease". Transfus. Apher. Sci. doi:10.1016/j.transci.2018.07.005. PMID 30064913.

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