Von Willebrand disease history and symptoms: Difference between revisions

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


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{{CMG}} {{shyam}}{{AE}} {{N.F}}


==Overview==
==Overview==
The symptoms of von Willebrand’s disease vary among patients, depending on the level of residual von Willebrand factor activity, the disease subtype, and to some extent, age and sex.<ref name="pmid18315614">{{cite journal| author=Nichols WL, Hultin MB, James AH, Manco-Johnson MJ, Montgomery RR, Ortel TL et al.| title=von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA). | journal=Haemophilia | year= 2008 | volume= 14 | issue= 2 | pages= 171-232 | pmid=18315614 | doi=10.1111/j.1365-2516.2007.01643.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18315614  }} </ref> Children with von Willebrand’s disease most frequently present with symptoms of bruising and epistaxis.<ref name="pmid26375306">{{cite journal| author=Sanders YV, Fijnvandraat K, Boender J, Mauser-Bunschoten EP, van der Bom JG, de Meris J et al.| title=Bleeding spectrum in children with moderate or severe von Willebrand disease: Relevance of pediatric-specific bleeding. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 12 | pages= 1142-8 | pmid=26375306 | doi=10.1002/ajh.24195 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26375306  }} </ref>


Adults patients with vWD mainly present with bleeding after surgery (example bleeding after dental extraction/surgery), mucosa-associated bleeding, [[menorrhagia|Heavy menstrual periods]] and [[postpartum hemorrhage|postpartum hemorrhage]]. Severe [[internal bleeding|internal]] or [[hemarthrosis|joint bleeding]] is rare (which only occurs in type 3 vWD). <ref name="pmid22918553">{{cite journal| author=de Wee EM, Sanders YV, Mauser-Bunschoten EP, van der Bom JG, Degenaar-Dujardin ME, Eikenboom J et al.| title=Determinants of bleeding phenotype in adult patients with moderate or severe von Willebrand disease. | journal=Thromb Haemost | year= 2012 | volume= 108 | issue= 4 | pages= 683-92 | pmid=22918553 | doi=10.1160/TH12-04-0244 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22918553  }} </ref>
Patients with von Willebrand disease present with history of [[Mucosal bleeding|mucosal bleeding,]] recurrent nose bleeds, [[Oral cavity|oral cavity bleeding]], and positive family history of similer symptoms among other family members. Adults patients with vWD mainly present with bleeding after [[Extraction (dental)|dental extraction]]/ or other surgery. [[menorrhagia|Heavy menstrual periods]] and [[postpartum hemorrhage|postpartum hemorrhage]] are common among affected females with von Willebrand’s disease. Severe [[internal bleeding|internal]] or [[hemarthrosis|joint bleeding]] can occur but is usually rare.


==Symptoms==
==Symptoms==
The symptoms of von Willebrand’s disease vary among patients, depending on the level of residual von Willebrand factor activity, the disease subtype, and to some extent, age and sex.<ref name="pmid18315614">{{cite journal| author=Nichols WL, Hultin MB, James AH, Manco-Johnson MJ, Montgomery RR, Ortel TL et al.| title=von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA). | journal=Haemophilia | year= 2008 | volume= 14 | issue= 2 | pages= 171-232 | pmid=18315614 | doi=10.1111/j.1365-2516.2007.01643.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18315614  }} </ref>


===Children===  
=== History ===
Children with von Willebrand’s disease most frequently present with symptoms of bruising and epistaxis.<ref name="pmid26375306">{{cite journal| author=Sanders YV, Fijnvandraat K, Boender J, Mauser-Bunschoten EP, van der Bom JG, de Meris J et al.| title=Bleeding spectrum in children with moderate or severe von Willebrand disease: Relevance of pediatric-specific bleeding. | journal=Am J Hematol | year= 2015 | volume= 90 | issue= 12 | pages= 1142-8 | pmid=26375306 | doi=10.1002/ajh.24195 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26375306 }} </ref>
Patients with von Willebrand disease may have a positive history of:<ref name="pmid18315614">{{cite journal| author=Nichols WL, Hultin MB, James AH, Manco-Johnson MJ, Montgomery RR, Ortel TL et al.| title=von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA). | journal=Haemophilia | year= 2008 | volume= 14 | issue= 2 | pages= 171-232 | pmid=18315614 | doi=10.1111/j.1365-2516.2007.01643.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18315614 }} </ref>
* Personal bleeding
* Family history of bleeding
* [[Bruising]] without obvious [[trauma]]
* Recurrent nose bleeds
* Oral cavity bleeding
* Bleeding from the gums after brushing or flossing teeth
* Prolonged bleeding following dental cleaning or extractions


===Adults===
=== Common Symptoms ===
Adults patients with vWD mainly present with the following:<ref name="pmid22918553">{{cite journal| author=de Wee EM, Sanders YV, Mauser-Bunschoten EP, van der Bom JG, Degenaar-Dujardin ME, Eikenboom J et al.| title=Determinants of bleeding phenotype in adult patients with moderate or severe von Willebrand disease. | journal=Thromb Haemost | year= 2012 | volume= 108 | issue= 4 | pages= 683-92 | pmid=22918553 | doi=10.1160/TH12-04-0244 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22918553  }} </ref>
Common symptoms of von Willebrand disease include:<ref name="pmid30046704">{{cite journal |vauthors=Keesler DA, Flood VH |title=Current issues in diagnosis and treatment of von Willebrand disease |journal=Res Pract Thromb Haemost |volume=2 |issue=1 |pages=34–41 |date=January 2018 |pmid=30046704 |pmc=5974913 |doi=10.1002/rth2.12064 |url=}}</ref>
 
* Easy [[bruising]]
*bleeding after surgery and trauma (The majority of patients (60 to 80%)
*Mucosa-associated bleeding
This usually may manifest in the form of the following:
*Easy bruising
*[[Epistaxis|Nosebleeds]]
*[[Epistaxis|Nosebleeds]]
* Oral cavity bleeding
* Oral cavity bleeding
*Bleeding after dental extraction/surgery
*Bleeding after dental extraction/surgery
*[[Menorrhagia|Heavy menstrual periods]]  
*[[Menorrhagia|Heavy menstrual periods]]  
* [[Postpartum hemorrhage|Postpartum hemorrhage]].  
* [[Postpartum hemorrhage|Postpartum hemorrhage]]  
*Severe [[internal bleeding|internal]] or [[hemarthrosis|joint bleeding]] is rare (which only occurs in type 3 vWD).
* [[Epistaxis]]
To make a diagnosis, there is usually personal or family history of bleeding and laboratory evidence of defective von Willebrand factor, factor VIII, or both.
 
=== Less Common Symptoms ===
Less common symptoms of von Willebrand’s disease include<ref name="pmid29878657">{{cite journal |vauthors=Leebeek FWG, Susen S |title=Von Willebrand disease: Clinical conundrums |journal=Haemophilia |volume=24 Suppl 6 |issue= |pages=37–43 |date=May 2018 |pmid=29878657 |doi=10.1111/hae.13508 |url=}}</ref>
* Severe [[internal bleeding|internal]] [[hemarthrosis|bleeding]]  
* [[hemarthrosis|Joint bleeding]]
* [[Gastrointestinal tract|Gastrointestinal]] bleeding


==References==
==References==

Latest revision as of 23:12, 20 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]Associate Editor(s)-in-Chief: Nazia Fuad M.D.

Overview

Patients with von Willebrand disease present with history of mucosal bleeding, recurrent nose bleeds, oral cavity bleeding, and positive family history of similer symptoms among other family members. Adults patients with vWD mainly present with bleeding after dental extraction/ or other surgery. Heavy menstrual periods and postpartum hemorrhage are common among affected females with von Willebrand’s disease. Severe internal or joint bleeding can occur but is usually rare.

Symptoms

History

Patients with von Willebrand disease may have a positive history of:[1]

  • Personal bleeding
  • Family history of bleeding
  • Bruising without obvious trauma
  • Recurrent nose bleeds
  • Oral cavity bleeding
  • Bleeding from the gums after brushing or flossing teeth
  • Prolonged bleeding following dental cleaning or extractions

Common Symptoms

Common symptoms of von Willebrand disease include:[2]

Less Common Symptoms

Less common symptoms of von Willebrand’s disease include[3]

References

  1. Nichols WL, Hultin MB, James AH, Manco-Johnson MJ, Montgomery RR, Ortel TL; et al. (2008). "von Willebrand disease (VWD): evidence-based diagnosis and management guidelines, the National Heart, Lung, and Blood Institute (NHLBI) Expert Panel report (USA)". Haemophilia. 14 (2): 171–232. doi:10.1111/j.1365-2516.2007.01643.x. PMID 18315614.
  2. Keesler DA, Flood VH (January 2018). "Current issues in diagnosis and treatment of von Willebrand disease". Res Pract Thromb Haemost. 2 (1): 34–41. doi:10.1002/rth2.12064. PMC 5974913. PMID 30046704.
  3. Leebeek F, Susen S (May 2018). "Von Willebrand disease: Clinical conundrums". Haemophilia. 24 Suppl 6: 37–43. doi:10.1111/hae.13508. PMID 29878657. Vancouver style error: initials (help)

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