Prepubertal Bleeding as a Presenting Symptom of Von Willebrand Disease: A Case Report

Von Willebrand disease (VWD) affects approximately 1% of the population and is often diagnosed after the presentation of mucocutaneous bleeding.

A 7-year-old girl with eczema and constipation presented to clinic reporting vaginal bleeding. External genital examination findings were normal, and results of a workup for precocious puberty were negative. Vaginoscopy revealed an atypical appearance with increased vascularity and friability. Oral mucosal bleeding at the time of extubation prompted additional workup and hematology referral, which led to diagnosis of type I VWD.

It is important to keep bleeding disorders on the differential, for unexplained prepubertal vaginal bleeding, to aid in prompt diagnosis.