Von Willebrand disease history and symptoms: Difference between revisions

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==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>
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.


==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’s 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>
* 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’s disease include:
 
* 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
Line 27: Line 28:
*[[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
* Severe [[internal bleeding|internal]] [[hemarthrosis|bleeding]]  
* [[hemarthrosis|Joint bleeding]]
* [[Gastrointestinal tract|Gastrointestinal]] bleeding


==References==
==References==

Revision as of 16:43, 31 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

Adults patients with vWD mainly present with bleeding after surgery (example bleeding after dental extraction/surgery), mucosa-associated bleeding, Heavy menstrual periods and postpartum hemorrhage. Severe internal or joint bleeding is rare.

Symptoms

History

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

  • 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’s disease include:

Less Common Symptoms

Less common symptoms of von Willebrand’s disease include

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.

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