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Cracking the Code: How Doctors Diagnose Von Willebrand Disease
Published: Sep 19, 2024
Diagnosing Von Willebrand Disease (VWD) is like solving a complex puzzle. It requires a combination of patient history, physical exams, and specialized blood tests.
The Bleeding History: Your Story Matters
The first step in diagnosing VWD is taking a detailed bleeding history. Doctors will ask about easy bruising, nosebleeds, heavy periods, and bleeding after surgeries or dental work. They might use a special questionnaire called a Bleeding Assessment Tool (BAT) to score your bleeding symptoms. It's like filling out a survey about your bleeding experiences - every detail counts!
Blood Tests: Measuring VWF Levels
The next step involves blood tests to measure the amount and function of von Willebrand factor (VWF) in your blood. These tests include VWF antigen (VWF:Ag) and VWF activity tests. Think of it like checking both the quantity and quality of VWF in your blood. Doctors also measure Factor VIII, another clotting protein that works closely with VWF.
Advanced Tests: Digging Deeper
If initial tests suggest VWD, doctors may perform more specialized tests. These can include VWF multimer analysis, which looks at the structure of VWF molecules, and genetic testing. It's like zooming in with a microscope to get a closer look at what's going on with your VWF.
Challenges in Diagnosis
Diagnosing VWD can be tricky because VWF levels can fluctuate due to stress, exercise, pregnancy, and other factors. Sometimes, repeat testing is necessary. It's like trying to photograph a moving target - you might need multiple shots to get it right.
Frequently Asked Questions
It can take several weeks to complete all necessary tests.
It's not ideal, as pregnancy can temporarily increase VWF levels.
No, but it can be helpful in certain types of VWD.
Yes, but interpretation may be more challenging in young children.
No, accurate diagnosis requires laboratory blood tests.
The Big Picture
While diagnosing VWD can be complex, advances in testing are making it more accurate and accessible.
References
- James PD, et al. ASH ISTH NHF WFH 2021 guidelines on the diagnosis of von Willebrand disease. Blood Adv 2021; 5:280.
- Sharma R, Flood VH. Advances in the diagnosis and treatment of Von Willebrand disease. Blood 2017; 130:2386.
- Elbatarny M, et al. Normal range of bleeding scores for the ISTH-BAT: adult and pediatric data from the merging project. Haemophilia 2014; 20:831.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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