von Willebrand Disease

Definition

von Willebrand disease (vWD) is a genetic blood disorder. It decreases the amount or the effectiveness of von Willebrand factor. This factor is a sticky protein. It helps make a plug at the site of an injury to stop bleeding. vWD can lead to bleeding problems.

There are 3 major types of vWD:

• Type 1—most mild and most common form
• Type 2—less common than type 1
• Type 3—most serious form and very rare

Genetic Material.

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Causes

vWD is caused by a gene problem. It is most often passed down from the parent.

A child can develop type 1 or type 2 vWD if just one parent has the gene problem. For type 3, both parents must have the gene problem. Some people may have the gene for vWD and not have bleeding problems. They can still pass this gene to their children.

vWD can be caused by other health issues or medicines. This is called acquired von Willebrand syndrome.

Risk Factors

The risk of vWD is higher in people with family members who have it.

Symptoms

Many people with the vWD gene do not have problems. It may be noticed after an injury or a procedure.

Symptoms usually start in childhood. They tend to waver throughout life. The seriousness will differ from person to person. They may involve:

• Easy bruising
• Frequent nosebleeds
• Bleeding from the gums and minor cuts
• Heavy bleeding during menstrual periods
• Blood in the urine
• Bleeding after childbirth or other trauma

Type 3 vWD can also result in serious bleeding with no clear cause. This type can also cause bleeding into the joints. This can cause joint swelling and pain.

Diagnosis

The doctor will ask about symptoms and health history. Symptoms and blood tests will confirm it and find the type.

Treatment

Many people with vWD do not need treatment for it. If needed, it depends on the type and seriousness of vWD. Most times, treatment is needed while having a medical or dental procedure.

This may involve:

• Desmopressin nasal spray or injection—Raises the level of vWF in the blood. It may be used to control bleeding in mild cases of type 1.
• IV infusions of von Willebrand factors—To control bleeding.
• Birth control pills—To control heavy menstrual periods in those with type 1 vWD.
• Antifibrinolytic medicine—For bleeding in the nose or mouth. It keeps a clot from being dissolved before the bleeding has stopped.
• Recombinant Factor VIIIa—If antibodies to von Willebrand Factor are formed.

Special steps are taken during childbirth for pregnant people with vWD.

Prevention

vWD cannot be prevented.