Abstract
Background and aims: Von Willebrand disease (VWD) is an inherited disorder of blood clotting in humans. The prevalence of VWD is different among various populations. The prevalence of this disorder in women with menorrhagia is less reported in Asia and Iran. The present study aimed to determine the prevalence of VWD in women of reproductive age with heavy menstrual bleeding (HMB).Materials and Methods: A total of 160 women in the reproductive age group (15-45 years) with HMB who referred to the hematology clinic of Kashan Shahid Beheshti hospital during 2019 participated in this cross-sectional study. Demographic characteristics, clinical testing, and physician-reported problems of each participate including age, menstrual cycle length, uterine myoma, and polyp were collected using a questionnaire, sonography, and physical examination of women by a physician. The laboratory tests included hemoglobin (Hb), ferritin, iron, and total iron-binding capacity (TIBC).Results: Fifteen patients (9.3%) with severe menstrual bleeding had VWD with a mean age of 34.60±6.85 years. The frequency of the uterine fibroid (myoma) in women with VWD was significantly higher than that in patients without VWD (p =0.03). The mean ferritin level among 15 women with VWD and 145 women without VWD was 23±4.28 ug/dL and 30.68±4.46 ug/dL, respectively (p =0.001). The mean serum iron in total participants was 35.3±11.48 ug/dL and VWD patients had a lower iron level compared to those without VWD (p =0.001). There was not a significant difference in TIBC level between women with and without VWD (p =0.6).Conclusion: Based on the results, 9.3% of women of reproductive age with HMB in Kashan, Iran, had VWD, which is lower compared to other regions of Asia.
Highlights
Von Willebrand disease (VWD) is an inherited disorder of blood clotting caused by a defect or deficiency in von Willebrand factor (VWF).[1]
Men and women are affected by this disorder; more women are diagnosed with VWD than men because of the menstrual bleeding and childbirth.[3]
Fifteen patients (9.3%) with severe menstrual bleeding had VWD with a mean age of 34.60±6.85 years
Summary
Von Willebrand disease (VWD) is an inherited disorder of blood clotting caused by a defect or deficiency in von Willebrand factor (VWF).[1]. More than 50% of cases have an unknown cause; HMB can be associated with other disorders such as hypothyroidism, endometriosis, endometritis, Abdoli et al endometrial polyps, polycystic ovary syndrome, uterine fibroids, uterine/cervical malignancy, and VWD.[8] A study showed that only 4% of gynecologists routinely considered VWD in the differential diagnosis in women of reproductive age.[9] Undiagnosed VWD can lead to serious problems including impairment of the quality of life during menses, anemia, and surgical procedures. Previous studies have shown that 78%-92% of women with VWD suffer from HMB,[10,11] compared with a prevalence of 24R55% in Iranian women of reproductive age.[12]. This study was conducted for the first time to determine the prevalence of VWD in women of reproductive age with severe menstrual bleeding in Kashan, Iran, during 2019
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