(Un) Diagnosing von Willebrand disease

Area of Science:

• Hematology
• Clinical Diagnostics

Background:

• Diagnosis of von Willebrand disease (VWD) presents challenges.
• Variability in laboratory assays, patient von Willebrand factor (VWF) levels, and VWD types complicates diagnosis.
• Accurate diagnosis is difficult, particularly in pediatric populations.

Purpose of the Study:

• To highlight the diagnostic challenges in von Willebrand disease (VWD).
• To emphasize the importance of clinical bleeding history in VWD diagnosis.
• To address the need for re-evaluation in older individuals with a prior VWD diagnosis.

Main Methods:

• Review of diagnostic criteria for von Willebrand disease (VWD).
• Emphasis on the role of clinical bleeding history assessment.
• Consideration of repeated laboratory testing and individual patient factors.

Main Results:

• Diagnostic variability stems from assay limitations and patient VWF level fluctuations.
• Clinical bleeding history is the most critical factor for accurate VWD diagnosis.
• Re-evaluation is necessary for older individuals potentially misdiagnosed with VWD.

Conclusions:

• Accurate von Willebrand disease (VWD) diagnosis requires integrating clinical history with laboratory data.
• Careful evaluation is crucial for both initial diagnosis and potential "undiagnosing" in older patients.
• Further research on aging and VWF is needed to refine diagnostic approaches.