RSS-Feed abonnieren
DOI: 10.1055/s-0031-1281034
Nordic Haemophilia Council's Practical Guidelines on Diagnosis and Management of von Willebrand Disease
Publikationsverlauf
Publikationsdatum:
18. November 2011 (online)

ABSTRACT
von Willebrand disease (VWD) is the most common inherited bleeding disorder characterized by spontaneous or tissue injury–related, mostly mucocutaneous, bleeding events. VWD affects both males and females and is caused by quantitative or qualitative deficiency of von Willebrand factor. The diagnostic procedure is complicated because VWD is highly heterogeneous, and differential diagnosis from platelet disorders may be challenging. Moreover, these defects may even coexist, impacting the bleeding phenotype. Mild and moderate VWD can be difficult to distinguish from the normal population, and VWD subtyping may also be problematic. This article summarizes the guidelines of the Nordic Haemophilia Council (NHC), which are intended to serve as a practical tool and provide the standards for diagnosing and treating VWD patients. The complete Nordic Guidelines on VWD are available at the NHC Web site (http://nordhemophilia.org).
KEYWORDS
von Willebrand disease - Nordic Haemophilia Council - Guidelines
REFERENCES
- 1
von Willebrand EA.
Hereditär pseudohemofili.
Finsk Lakaresallsk Handl.
1926;
68
87-112
MissingFormLabel
- 2
Sadler JE, Budde U, Eikenboom JC Working Party on von Willebrand Disease Classification et al.
Update on the pathophysiology and classification of von Willebrand disease: a report of the Subcommittee on von Willebrand Factor.
J Thromb Haemost.
2006;
4
(10)
2103-2114
MissingFormLabel
- 3
Tosetto A, Rodeghiero F, Castaman G et al..
A quantitative analysis of bleeding symptoms in type 1 von Willebrand disease: results from a multicenter European study (MCMDM-1 VWD).
J Thromb Haemost.
2006;
4
(4)
766-773
MissingFormLabel
- 4
Bowman M, Mundell G, Grabell J et al..
Generation and validation of the condensed MCMDM-1VWD bleeding questionnaire for von Willebrand disease.
J Thromb Haemost.
2008;
6
(12)
2062-2066
MissingFormLabel
- 5
Mannucci PM.
Desmopressin (DDAVP) in the treatment of bleeding disorders: the first twenty years.
Haemophilia.
2000;
6
(Suppl 1)
60-67
MissingFormLabel
- 6
Berntorp E, Önundarson PT.
Prevalence of von Willebrand disease in the Nordic region.
Haematologica Rep.
2005;
1
4-6
MissingFormLabel
- 7
Favaloro EJ.
An update on the von Willebrand factor collagen binding assay: 21 years of age and beyond adolescence
but not yet a mature adult.
Semin Thromb Hemost.
2007;
33
(8)
727-744
MissingFormLabel
- 8
Baronciani L, Federici AB, Cozzi G, Canciani MT, Mannucci PM.
von Willebrand factor collagen binding assay in von Willebrand disease type 2A, 2B, and 2M.
J Thromb Haemost.
2006;
4
(9)
2088-2090
MissingFormLabel
- 9
Goodeve A, Eikenboom J, Castaman G et al..
Phenotype and genotype of a cohort of families historically diagnosed with type 1
von Willebrand disease in the European study, Molecular and Clinical Markers for the
Diagnosis and Management of Type 1 von Willebrand Disease (MCMDM-1VWD).
Blood.
2007;
109
(1)
112-121
MissingFormLabel
- 10
Lethagen S, Hillarp A, Ekholm C, Mattson E, Halldén C, Friberg B.
Distribution of von Willebrand factor levels in young women with and without bleeding symptoms: influence
of ABO blood group and promoter haplotypes.
Thromb Haemost.
2008;
99
(6)
1013-1018
MissingFormLabel
- 11
Onundarson PT, Gudmundsdottir BR, Arnfinnsdottir AV, Kjeld M, Olafsson O.
von Willebrand factor does not vary during normal menstrual cycle.
Thromb Haemost.
2001;
85
(1)
183-184
MissingFormLabel
- 12
Sadler JE, Rodeghiero F. ISTH SSC Subcommittee on von Willebrand Factor .
Provisional criteria for the diagnosis of VWD type 1.
J Thromb Haemost.
2005;
3
(4)
775-777
MissingFormLabel
- 13
Gudmundsdottir BR, Marder VJ, Onundarson PT.
Risk of excessive bleeding associated with marginally low von Willebrand factor and mild platelet dysfunction.
J Thromb Haemost.
2007;
5
(2)
274-281
MissingFormLabel
- 14
Eikenboom J, Van Marion V, Putter H et al..
Linkage analysis in families diagnosed with type 1 von Willebrand disease in the European study, molecular and clinical markers for the
diagnosis and management of type 1 VWD.
J Thromb Haemost.
2006;
4
(4)
774-782
MissingFormLabel
- 15
Sadler JE.
Low von Willebrand factor: sometimes a risk factor and sometimes a disease.
Hematology Am Soc Hematol Educ Program.
2009;
106-112
MissingFormLabel
- 16
Favaloro EJ.
Toward a new paradigm for the identification and functional characterization of von Willebrand disease.
Semin Thromb Hemost.
2009;
35
(1)
60-75
MissingFormLabel
- 17
Holmberg L, Dent JA, Schneppenheim R, Budde U, Ware J, Ruggeri ZM.
von Willebrand factor mutation enhancing interaction with platelets in patients with
normal multimeric structure.
J Clin Invest.
1993;
91
(5)
2169-2177
MissingFormLabel
- 18
Schneppenheim R, Federici AB, Budde U et al..
von Willebrand disease type 2M “Vicenza” in Italian and German patients: identification
of the first candidate mutation (G3864A; R1205H) in 8 families.
Thromb Haemost.
2000;
83
(1)
136-140
MissingFormLabel
- 19
Mazurier C, Goudemand J, Hilbert L, Caron C, Fressinaud E, Meyer D.
Type 2N von Willebrand disease: clinical manifestations, pathophysiology, laboratory diagnosis
and molecular biology.
Best Pract Res Clin Haematol.
2001;
14
(2)
337-347
MissingFormLabel
- 20
Casonato A, Pontara E, Sartorello F et al..
Identifying carriers of type 2N von Willebrand disease: procedures and significance.
Clin Appl Thromb Hemost.
2007;
13
(2)
194-200
MissingFormLabel
- 21
Eikenboom JC.
Congenital von Willebrand disease type 3: clinical manifestations, pathophysiology and molecular
biology.
Best Pract Res Clin Haematol.
2001;
14
(2)
365-379
MissingFormLabel
- 22
Castaman G, Rodeghiero F, Tosetto A et al..
Hemorrhagic symptoms and bleeding risk in obligatory carriers of type 3 von Willebrand disease: an international, multicenter study.
J Thromb Haemost.
2006;
4
(10)
2164-2169
MissingFormLabel
- 23
Favaloro EJ, Patterson D, Denholm A et al..
Differential identification of a rare form of platelet-type (pseudo-) von Willebrand disease (VWD) from type 2B VWD using a simplified ristocetin-induced-platelet-agglutination
mixing assay and confirmed by genetic analysis.
Br J Haematol.
2007;
139
(4)
623-626
MissingFormLabel
- 24
Franchini M, Lippi G.
Acquired von Willebrand syndrome: an update.
Am J Hematol.
2007;
82
(5)
368-375
MissingFormLabel
- 25
Federici AB, Budde U, Rand JH.
Acquired von Willebrand syndrome 2004: International Registry—diagnosis and management from
online to bedside.
Hamostaseologie.
2004;
24
(1)
50-55
MissingFormLabel
- 26
Lethagen S, Harris AS, Sjörin E, Nilsson IM.
Intranasal and intravenous administration of desmopressin: effect on F VIII/vWF, pharmacokinetics
and reproducibility.
Thromb Haemost.
1987;
58
(4)
1033-1036
MissingFormLabel
- 27
Lethagen S, Ragnarson Tennvall G.
Self-treatment with desmopressin intranasal spray in patients with bleeding disorders:
effect on bleeding symptoms and socioeconomic factors.
Ann Hematol.
1993;
66
(5)
257-260
MissingFormLabel
- 28
Castaman G, Lethagen S, Federici AB et al..
Response to desmopressin is influenced by the genotype and phenotype in type 1 von Willebrand disease (VWD): results from the European Study MCMDM-1VWD.
Blood.
2008;
111
(7)
3531-3539
MissingFormLabel
- 29
Smith TJ, Gill JC, Ambruso DR, Hathaway WE.
Hyponatremia and seizures in young children given DDAVP.
Am J Hematol.
1989;
31
(3)
199-202
MissingFormLabel
- 30
Lethagen S, Kyrle PA, Castaman G, Haertel S, Mannucci PM. HAEMATE P Surgical Study Group .
von Willebrand factor/factor VIII concentrate (Haemate P) dosing based on pharmacokinetics:
a prospective multicenter trial in elective surgery.
J Thromb Haemost.
2007;
5
(7)
1420-1430
MissingFormLabel
- 31
Warkentin TE, Moore JC, Anand SS, Lonn EM, Morgan DG.
Gastrointestinal bleeding, angiodysplasia, cardiovascular disease, and acquired von Willebrand syndrome.
Transfus Med Rev.
2003;
17
(4)
272-286
MissingFormLabel
- 32
Berntorp E, Petrini P.
Long-term prophylaxis in von Willebrand disease.
Blood Coagul Fibrinolysis.
2005;
16
(Suppl 1)
S23-S26
MissingFormLabel
- 33
Sucker C, Scharf RE, Zotz RB.
Use of recombinant factor VIIa in inherited and acquired von Willebrand disease.
Clin Appl Thromb Hemost.
2009;
15
(1)
27-31
MissingFormLabel
Riitta LassilaM.D. Ph.D.
Unit of Coagulation Disorders
PoB 340, FI-00029HUS, Helsinki, Finland
eMail: riitta.lassila@hus.fi