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J. Clin. Med. 2017, 6(4), 45; doi:10.3390/jcm6040045

Diagnosis and Treatment of von Willebrand Disease and Rare Bleeding Disorders

Center for Bleeding Disorders and Coagulation, Department of Oncology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
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Academic Editor: Emmanuel Andrès
Received: 23 February 2017 / Revised: 4 April 2017 / Accepted: 5 April 2017 / Published: 10 April 2017
(This article belongs to the Special Issue Outstanding Advances in Hemophilia Therapies)
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Abstract

Along with haemophilia A and B, von Willebrand disease (VWD) and rare bleeding disorders (RBDs) cover all inherited bleeding disorders of coagulation. Bleeding tendency, which can range from extremely severe to mild, is the common symptom. VWD, due to a deficiency and/or abnormality of von Willebrand factor (VWF), represents the most frequent bleeding disorder, mostly inherited as an autosomal dominant trait. The diagnosis may be difficult, based on a bleeding history and different diagnostic assays, which evaluate the pleiotropic functions of VWF. Different treatment options are available for optimal management of bleeding and their prevention, and long-term outcomes are generally good. RBDs are autosomal recessive disorders caused by a deficiency of any other clotting factor, apart from factor XII, and cover roughly 5% of all bleeding disorders. The prevalence of the severe forms can range from 1 case in 500,000 up to 1 in 2–3 million, according to the defect. Diagnosis is based on bleeding history, coagulation screening tests and specific factor assays. A crucial problem in RBDs diagnosis is represented by the non-linear relationship between clinical bleeding severity and residual clotting levels; genetic diagnosis may help in understanding the phenotype. Replacement therapies are differently available for patients with RBDs, allowing the successful treatment of the vast majority of bleeding symptoms. View Full-Text
Keywords: inherited disorder; von Willebrand factor; clotting factor deficiency; bleeding; desmopressin; replacement therapy; on-demand; prophylaxis inherited disorder; von Willebrand factor; clotting factor deficiency; bleeding; desmopressin; replacement therapy; on-demand; prophylaxis
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Castaman, G.; Linari, S. Diagnosis and Treatment of von Willebrand Disease and Rare Bleeding Disorders. J. Clin. Med. 2017, 6, 45.

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