Managing Patients with Low von Willebrand Factor Levels

Von Willebrand disease (VWD) is one of the most common congenital hemorrhagic disorders, yet it is often misdiagnosed or treated inappropriately.

To address misconceptions about this bleeding condition, two experts now present illustrative cases and discuss management options:

• Patients presenting with a history of unusual bleeding should have measurements of von Willebrand factor (VWF) and exclusion of other causes of bleeding such as hypothyroidism, collagen vascular disease, and abnormalities of platelets or other clotting factors.

• VWF levels <30 IU/dL usually occur in association with VWF gene mutations and are consistent with type 1 VWD.

• Smaller decreases in VWF (30 to 50 IU/dL) are infrequently due to gene mutations, and patients with thes…