Phenotypic implications of a co-existent haemorrhagic and thrombotic genotype

Inherited bleeding disorders such as Von Willebrands disease (VWD) present with varying bleeding tendencies in different individuals. There have been several attempts to identify the determinants for this varying severity of the haemorrhagic manifestations, especially in those with milder forms or type 1 VWD. Genetic mutations have been noted in persons with haemophilia to be contributing to a milder bleeding phenotype. This report describes the clinical implications of a similar mixed haemorrhagic-thrombotic genotype.