von Willebrand Disease

Autosomal dominant.  Genotypically common (maybe 1% of population), but vast majority never have problems (maybe because the Dx not sought).
  • May be common cause of menorrhagia
  • Consider in pt with easy bruising, frequent/prolonged epistaxis, bleeding gums, etc.
  • Sx may be provoked by aspirin use
Diagnosis:  Order “von Willebrand Panel”:
  • Plasma VW Factor Antigen
  • Plasma VW Factor Activity (aka ristocetin cofactor activity)
  • Plasma Factor VIII activity

If any of the above are abnormally low, send to Hematology for Dx and Tx.