NHLBI issues first US von Willebrand Disease clinical practice ...(l for physicians to take a complete medi...)

The symptoms of VWD include frequent large bruises from minor bumps or injuries, frequent or hard-to-stop nosebleeds, extended bleeding from the gums after a dental procedure, heavy bleeding after a cut or after surgery, and heavy or extended menstrual bleeding in women. The guidelines provide physicians with recommendations for diagnosing and treating the three major types of VWD, said William L. Nichols, Jr., M.D., associate professor of medicine at the Mayo Clinic in Rochester, Minn., and chairman of the NHLBI expert panel that developed the guidelines. While von Willebrand Disease cannot be cured, it can be treated. Proper diagnosis is important, and with the right treatment plan, even people with type 3 VWD, the most serious form, can live active lives.

The guidelines address the three types of von Willebrand disease.

• In type 1 VWD, patients have a low level of the von Willebrand factor, and may have lower than normal levels of factor VIII. This is the mildest and most common form of VWD. About three out of every four people with VWD have type 1 VWD.

• In type 2 VWD, the von Willebrand factor does not work the way it's supposed to. Type 2 VWD is divided into subtypes 2A, 2B, 2M, and 2N. Each type is caused by different gene mutations and treated differently.

• In type 3 VWD, patients usually have no von Willebrand factor and low levels of factor VIII. Type 3 is the most serious form of VWD, but is very rare.

People with type 1 or type 2 VWD may not have major bleeding problems, according to Nichols, and, as a result, they may not be diagnosed until they have heavy bleeding after surgery or some other trauma. On the other hand, type 3 VWD can cause major bleeding problems duri
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