Determination of von willebrand factor antigen in patients with undiagnosed menorrhagia

Abstract

This prospective study is about screening of von willbrand antigen in patients with undiagnosed menorrhagia, because the underlying cause may be haematological disorder in 50% of cases. To estimate the incidence of von willbrand disease in patients with undiagnosed menorrhagia. During the period of 2 months from February to april 2005, total of 50 patients were included in this study that were referred to Al-yarmok teaching hospital. The age range of these patients was 18-45 year. Full history and physical examination done, ultrasound examination to exclude local causes of menorrhagia, thyroid function done. 30 healthy volunteer age matched were included as control group. For each patient and control group the following tests were done: Bleeding time, Prothrombin time, Activated partial thromboplastin time, Factor 8 level, Von willbrand factor antigen level.Results1.There was no obvious or statistically significant difference in mean bleeding time and activated partial thromboplastine time observed between healthy controls and patients with menorrhagia.2.The mean Von Willebrand factor antigen (%) was significantly lower in patients with menorrhagia compared with healthy controls.3.The mean Von Willebrand factor antigen was slightly lower at the older age group compared to younger age group.4.The proportion of patients with prolonged activated partial thromboplastine time was obviously higher among those with abnormally low Von Willebrand factor antigen compared to those with acceptable level.5.The relative frequency of cases with abnormally low factor VIII activity was higher among subjects with other bleeding manifestations compared to those with no manifestations. 6.The relative frequency of cases with abnormally low factor VIII activity was higher among subjects with positive family history of bleeding tendency. 7.The relative frequency of cases with abnormally low Von Willebrand factor was obviously higher among subjects with other bleeding manifestations compared to those with no bleeding manifestations, also it was higher among cases with positive family history of bleeding tendency and those with past history of severe bleeding episodes.Conclusions: The prevalence of Von Willebrand disease is increased in women with menorrhagia. So it is reasonable to believe that Von Willebrand disease is the underlying cause for meborrhagia in a small but significant proportion of women. This study revealed that 6% of women with menorrhagia had Von Willebrand disease.