№ 20Hematology15 min read
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 | Key lab idea |
|---|---|---|
| Platelet disorder | Petechiae, mucosal bleeding | Platelet count/function abnormal |
| Haemophilia A/B | Deep bleeding, haemarthrosis | Isolated prolonged aPTT |
| vWD | Mostly mucocutaneous bleeding; severe types may mimic haemophilia | Abnormal vWF antigen/activity ± low FVIII |
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