Von Willebrand disease (VWD) is a bleeding disorder. People with the disorder sometimes bruise easily or bleed too much when they get cut. VWD is the most common inherited bleeding disorder, affecting up to 1% of the population.

Causes of vWD

VWD is caused by an abnormal gene and runs in families. In some cases, a family might not know about it if the disease is mild. VWD is a genetic disorder caused by missing or defective von Willebrand factor (VWF), a clotting protein. VWF binds factor VIII, a key clotting protein, and platelets in blood vessel walls, which help form a platelet plug during the clotting process.

Symptoms

People with VWD experience frequent nosebleeds, easy bruising and excessive bleeding during and after invasive procedures, such as tooth extractions and surgery. Women often experience heavy menstrual bleeding (heavy menstrual periods that last longer than average), and hemorrhaging after childbirth

The possible symptoms of vWD are:

• Easy bruising.
• Frequent or prolonged epistaxis (more than 30 minutes).
• Bleeding gums.
• Prolonged bleeding from minor wounds.
• If the menstrual volume is excessive (resulting in repeated iron-deficiency anemia), or the menstrual period is prolonged (for example, the menstrual period exceeds seven days, etc.), a menstrual bleeding scale can be used to evaluate whether the menstrual volume is excessive.
• Recurrent upper and lower gastrointestinal bleeding.
• Prolonged bleeding after injury, surgery, or dental surgery.

Many vWD patients have mild or no symptoms, while severe vWD patients may have more bleeding problems, and their symptoms may change with time. Most patients will only discover that they have vWD after a serious accident, or after a dental or surgical operation that causes prolonged bleeding or poor wound healing.

Diagnosis

• vWD is not easy to be diagnosed. If you suspect that you have bleeding problems, you should consult a hematologist. The Hemophilia Center can conduct regular tests. Since VWF protein has many functions, it needs many laboratory tests to identify vWD types.

vWD types

• The three types of vWD are:

Treatment

Instructions

• Carry with you the treatment manual, which contains information about the disease you are suffering from, as well as the name or telephone number of the doctor or hemophilia center. In case of emergency, the medical staff can learn about your disease from the manual or other labels.
• Parents should inform the school of basic knowledge of vWD and the corresponding knowledge of handling skills. The most common symptom students encounter on campus is epistaxis.
• Register or visit a hemophilia center, which provides the highest level of care and services.
• Consult your doctor before using any drug. Avoid using over-the-counter drugs that interfere with blood clotting.
• Exercise regularly to keep your joints and muscles strong and healthy.
• Before traveling, please check the address and telephone number of the local hemophilia center and take the information with you.
• Once those with vWD get pregnant, please inform your obstetrician-gynecologist. He/she should cooperate with the doctor of the hemophilia center so as to provide the best medical treatment for you during pregnancy and delivery.