eMedicine Specialties > Hematology > Coagulation, Hemostasis, and Disorders

von Willebrand Disease: Follow-up

Author: Eleanor S Pollak, MD, Associate Director of Special Coagulation, Associate Professor, Department of Pathology and Laboratory Medicine, Section of Hematology and Coagulation, University of Pennsylvania
Contributor Information and Disclosures

Updated: Aug 13, 2009

Follow-up

Further Outpatient Care

  • Because of the effects of stress on the expression of vWF, laboratory testing should be repeated in patients with newly diagnosed vWD.

Inpatient & Outpatient Medications

  • Medications should be recommended as necessary for prophylactic and therapeutic treatment of vWD.

Deterrence/Prevention

  • Advise patients to avoid aspirin-containing compounds.

Patient Education

  • Patients should be instructed about their coagulation disorder and should be aware of the conditions in which they will require prophylactic therapy.
  • For excellent patient education resources, visit eMedicine's Skin, Hair, and Nails Center. Also, see eMedicine's patient education article Bruises.

Miscellaneous

Medicolegal Pitfalls

  • Failure to obtain a consultation with a hematologist prior to surgical procedures and dental extractions in patients with vWD
  • Failure to obtain a bleeding history in patients undergoing surgical procedures or dental extractions
  • Failure to test older patients who received cryoprecipitate or plasma in the past for HIV1 and viral hepatitis infections
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Dr Steven Stein to the development and writing of this article.



More on von Willebrand Disease

Overview: von Willebrand Disease
Differential Diagnoses & Workup: von Willebrand Disease
Treatment & Medication: von Willebrand Disease
Follow-up: von Willebrand Disease
References
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References

  1. Conti M, Mari D, Conti E, et al. Pregnancy in women with different types of von Willebrand disease. Obstet Gynecol. Aug 1986;68(2):282-5. [Medline].

  2. Mannucci PM. Desmopressin (DDAVP) in the treatment of bleeding disorders: the first 20 years. Blood. Oct 1 1997;90(7):2515-21. [Medline].

  3. Mannucci PM. Hemostatic drugs. N Engl J Med. Jul 23 1998;339(4):245-53. [Medline].

  4. Mannucci PM. How I treat patients with von Willebrand disease. Blood. Apr 1 2001;97(7):1915-9. [Medline].

  5. Nichols WL, Hultin MB, James AH, et al, and the NHLBI von Willebrand Disease Expert Panel. The Diagnosis, Evaluation, and Management of von Willebrand Disease. Bethesda, Md: National Heart, Lung, and Blood Institute. NIH publication no. 08-5832. December 2007. Available at http://www.nhlbi.nih.gov/guidelines/vwd/index.htm. Accessed September 30, 2008.

  6. Sadler JE, for the Subcommittee on von Willebrand Factor of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. A revised classification of von Willebrand disease. Thromb Haemost. Apr 1994;71(4):520-5. [Medline].

  7. Sadler JE. Von Willebrand Disease. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds. The Metabolic and Molecular Bases of Inherited Disease. Vol 3. 8th ed. New York, NY: McGraw-Hill; 2001:. 4415-31.

  8. Sadler JE, Mannucci PM, Berntorp E, et al. Impact, diagnosis and treatment of von Willebrand disease. Thromb Haemost. Aug 2000;84(2):160-74. [Medline].

  9. Tout H, Obert B, Houllier A, et al. Mapping and functional studies of two alloantibodies developed in patients with type 3 von Willebrand disease. Thromb Haemost. Feb 2000;83(2):274-81. [Medline].

  10. Rodeghiero F, Castaman G, Tosetto A. How I treat von Willebrand disease. Blood. Aug 6 2009;114(6):1158-65. [Medline]. [Full Text].

  11. Franchini M, Targher G, Montagnana M, Lippi G. Antithrombotic prophylaxis in patients with von Willebrand disease undergoing major surgery: when is it necessary?. J Thromb Thrombolysis. Aug 2009;28(2):215-9. [Medline].

  12. Udvardy ML, Szekeres-Csiki K, Hársfalvi J. Novel evaluation method for densitometric curves of von Willebrand Factor multimers and a new parameter (M(MW)) to describe the degree of multimersation. Thromb Haemost. Aug 2009;102(2):412-7. [Medline].

  13. Sutherland MS, Cumming AM, Bowman M, et al. A novel deletion mutation is recurrent in von Willebrand disease types 1 and 3. Blood. Jul 30 2009;114(5):1091-8. [Medline].

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Further Reading

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Keywords

von Willebrand disease, von Willebrand's disease, vWD, VWD, hemophilia, von Willebrand factor, VWF, vWF, angiohemophilia, vascular hemophilia, mucocutaneous bleeding disorder, primary hemostasis impairment, bleeding disorder, hemorrhagic disorder, hematological disorder, partial quantitative deficiency, qualitative deficiency, total deficiency, inherited blood coagulation disorder, coagulation protein disorder, blood platelet disorder

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Contributor Information and Disclosures

Author

Eleanor S Pollak, MD, Associate Director of Special Coagulation, Associate Professor, Department of Pathology and Laboratory Medicine, Section of Hematology and Coagulation, University of Pennsylvania
Eleanor S Pollak, MD is a member of the following medical societies: American Society of Hematology, College of American Pathologists, and National Multiple Sclerosis Society
Disclosure: Nothing to disclose.

Medical Editor

Koyamangalath Krishnan, MD, FRCP, FACP, Paul Dishner Endowed Chair of Excellence in Medicine, Professor of Medicine and Chief of Hematology-Oncology, Program Director, Hematology-Oncology Fellowship, James H Quillen College of Medicine at East Tennessee State University
Koyamangalath Krishnan, MD, FRCP, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society of Hematology, and Royal College of Physicians
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Marcel E Conrad, MD, (Retired) Distinguished Professor of Medicine, University of South Alabama
Marcel E Conrad, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for the Advancement of Science, American Association of Blood Banks, American Chemical Society, American College of Physicians, American Physiological Society, American Society for Clinical Investigation, American Society of Hematology, Association of American Physicians, Association of Military Surgeons of the US, International Society of Hematology, Society for Experimental Biology and Medicine, and Southwest Oncology Group
Disclosure: No financial interests None None

CME Editor

Rajalaxmi McKenna, MD, FACP, Consulting Staff, Department of Medicine, Southwest Medical Consultants, SC, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Emmanuel C Besa, MD, Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Thomas Jefferson University
Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Hematology, and New York Academy of Sciences
Disclosure: Nothing to disclose.

 
 
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