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Case report
Published online: 2021-09-22
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Diagnostics and treatment of prolonged menstrual bleedings in girls with von Willebrand disease

Paweł Łaguna1, Andrzej Mital2
Affiliations
  1. Katedra i Klinika Onkologii, Hematologii Dziecięcej, Transplantologii Klinicznej i Pediatrii, Warszawski Uniwersytet Medyczny, Poland
  2. Klinika Hematologii i Transplantologii, Gdański Uniwersytet Medyczny

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Ahead of print
CASE REPORTS
Published online: 2021-09-22

Abstract

Von Willebrand disease (vWD) is the most common inherited bleeding disorder. Often it remains undiagnosed, despite pronounced symptoms including recurrent nose and gum bleeds, easy bruising and prolonged menstrual bleedings [1, 2]. Due to bleeds leading to blood loss and iron deficiency, anemia is one of the most common consequences of vWD. In this paper we present cases of teenager and adult women who, despite antifibrinolytic and hormonal treatment, suffered from prolonged bleeds leading to deep anemia requiring multiple blood transfusions. These symptoms prompted extended diagnostics leading to the diagnosis of vWD. Initiation of periodic prophylaxis with vW/VIII factor alleviated the symptoms.

Abstract

Von Willebrand disease (vWD) is the most common inherited bleeding disorder. Often it remains undiagnosed, despite pronounced symptoms including recurrent nose and gum bleeds, easy bruising and prolonged menstrual bleedings [1, 2]. Due to bleeds leading to blood loss and iron deficiency, anemia is one of the most common consequences of vWD. In this paper we present cases of teenager and adult women who, despite antifibrinolytic and hormonal treatment, suffered from prolonged bleeds leading to deep anemia requiring multiple blood transfusions. These symptoms prompted extended diagnostics leading to the diagnosis of vWD. Initiation of periodic prophylaxis with vW/VIII factor alleviated the symptoms.
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Keywords

von Willebrand disease, vWD, prolonged menses, bleeding prophylaxis

About this article
Title

Diagnostics and treatment of prolonged menstrual bleedings in girls with von Willebrand disease

Journal

Journal of Transfusion Medicine

Issue

Ahead of print

Article type

Case report

Published online

2021-09-22

Keywords

von Willebrand disease
vWD
prolonged menses
bleeding prophylaxis

Authors

Paweł Łaguna
Andrzej Mital

References (8)
  1. Mital A. Haemate P − zastosowanie w profilaktyce i leczeniu krwawień w chorobie von Willebranda oraz indukcji immunotolerancji w hemofilii A powikłanej inhibitorem. Acta Haematol Pol. 2017; 48(2): 125–129.
  2. Zdziarska J, Chojnowski K, Klukowska A, et al. Postępowanie w chorobie von Willebranda. Zalecenia Polskiego Towarzystwa Hematologów i Transfuzjologów 2008. Med Prakt (wyd. spec.). 2008: 12.
  3. James PD, Connell NT, Ameer B, et al. 2021 guidelines on the diagnosis of von Willebrand disease. Blood Adv. 2021; 5(1): 280–300.
  4. Ragni MV, Machin N, Malec LM, et al. Von Willebrand factor for menorrhagia: a survey and literature review. Haemophilia. 2016; 22(3): 397–402.
  5. Elbatarny M, Mollah S, Grabell J, et al. Normal range of bleeding scores for the ISTH-BAT: adult and pediatric data from the merging project. Haemophilia. 2014; 20(6): 831–835.
  6. Nilsson IM, Blomback M, Blomback B. v. Willebrand's disease in Sweden; its pathogenesis and treatment. Acta Med Scand. 1959; 164: 263–278.
  7. Berntorp E, Petrini P. Long-term prophylaxis in von Willebrand disease. Blood Coagul Fibrinolysis. 2005; 16 (Suppl. 1): S23–S26.
  8. Connell NT, Flood VH, Brignardello-Petersen R, et al. ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease. Blood Adv. 2021; 5(1): 301–325.

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