von Willebrand’s disease

1. Big picture

von Willebrand disease (vWD) is the most common inherited bleeding disorder and the classic disease that sits between:

• Platelet-type bleeding because von Willebrand factor (vWF) is needed for platelet adhesion.
• Coagulation-type bleeding because vWF carries and stabilizes factor VIII (FVIII).

So the exam pattern is:

Recurrent epistaxis + gum bleeding + easy bruising + menorrhagia + bleeding after tooth extraction/tonsillectomy ± prolonged bleeding time/PFA ± prolonged activated partial thromboplastin time (aPTT) → think von Willebrand disease.

Key contrast:

| Disease | Bleeding pattern |