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Hemostatic profile detailing in apparent VWD cases: A cross sectional study
Fatmah S Alqahtany1, Hanan B ALBackr2, Lateefa O Aldakhil3
1Hematopathology Unit, Department of Pathology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Saudi Journal of Biological Sciences
|December 6, 2021
Summary
Von Willebrand disease (vWD), a common bleeding disorder, was found in 6.6% of menorrhagia patients. Diagnosis was aided by significantly lower vWF:Ac and vWF:Ag levels in affected women.
Area of Science:
- Hematology
- Gynecology
- Clinical Diagnostics
Background:
- Von Willebrand disease (vWD) is a prevalent hereditary bleeding disorder affecting primary hemostasis and potentially Factor VIII levels.
- Diagnosing vWD can be challenging, particularly in patients presenting with menorrhagia, due to limitations in earlier diagnostic criteria.
- Menorrhagia is a common gynecological complaint, and its association with underlying bleeding disorders like vWD requires further investigation.
Purpose of the Study:
- To investigate the prevalence of Von Willebrand disease (vWD) in adult female patients experiencing menorrhagia.
- To evaluate the diagnostic utility of specific von Willebrand factor (vWF) assays in identifying vWD in this patient population.
- To compare hematological and coagulation parameters between patients with and without vWD.
Main Methods:
- A cross-sectional study was conducted at King Saud University Medical City, involving 45 adult female patients (16-45 years) with menorrhagia.
- Patients were screened for vWD, and demographic and clinical data were collected.
- Statistical analysis included Fisher's exact test and independent samples t-test, with a P value of ≤0.05 considered significant. Assays included vWF:Ac, vWF:Ag, and standard coagulation tests.
Main Results:
- Von Willebrand disease (vWD) was identified in 6.6% (n=3) of the 45 menorrhagia patients studied.
- Patients diagnosed with vWD exhibited significantly lower mean levels of vWF:Ac (51.4 ± 6.3) and vWF:Ag (93 ± 67) compared to non-vWD patients (98.7 ± 22.6 and 116 ± 42.4, respectively) (p=0.027, p=0.032).
- No significant differences were observed in WBC, ESR, MCV, MCH, Hemoglobin, PLT count, INR, PT, APTT, or FVIII levels between the groups (p > 0.05).
Conclusions:
- Von Willebrand disease (vWD) is present in a notable percentage of women with menorrhagia, highlighting the importance of screening.
- Reduced levels of vWF:Ac and vWF:Ag are significant indicators for diagnosing vWD in patients with heavy menstrual bleeding.
- Standard coagulation tests and other hematological parameters may not be sensitive enough to detect vWD in menorrhagic patients.
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