Von Willebrand disease: a report of 3 cases diagnosed with different contexts and review of literature

Abstract

Background: Von Willebrand disease is the most common human inherited bleeding disorder. A major challenge for affected patients is achieving an accurate and timely diagnosis. We reported 3 cases of von Willebrand disease diagnosed with different contexts. Case report: Case 1: male, 2.5 months old, whose grandfather and aunt have a bleeding disorder. Hospitalized with purpura and ecchymosis. Was diagnosed with VWD type 1 and monitored at home when bleeding. Case 2: male, 13 years old, diagnosed with Hemophilia A from 2 years old. Unresponsive to treatment, bleeding of the skin and mucosa. Diagnosis of VWD type 1. Treating with cryoprecipitate and oral minirin, the frequency of hospitalization is reduced and well-response. Case 3: female, 9 years old, hospitalized because of a centipede bite. After 4 days, the skin was bleeding with purpura and ecchymosis, and the laboratory showed prolonged APTT and decreased VWF antigen. Diagnosis of acquired VWD after a centipede bite. After 1 month of follow-up, the child did not bleed, and the test returned to normal. Conclusion: The cases described above help to generalize the different diagnostic contexts. The suggestion of VWD is raised when there is a mismatch between clinical and general coagulation tests. A definitive diagnosis of VWD requires a VWF test. Key words: von Willebrand disease, Bleeding disorder, von Willebrand factor