Replacement therapies. Its a brain bleed. Another replacement therapy approved by the Food and Drug Administration for treating adults 18 and older is a genetically engineered (recombinant) von Willebrand factor product. Because von Willebrand disease can be transmitted as an autosomal dominant or recessive trait, the fetus can have up to a 50% risk of being affected. Want to talk about Multiple Myeloma: Anyone else? The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Collaboration with a hematologist is recommended to aid in the planning for gynecologic surgery and obstetric management (see Ref later in this document). This is known as acquired von Willebrand syndrome, and it's likely caused by an underlying medical condition. You still have small amounts of VWF in your body to help clot . Pocket Guide for the Guidelines pdf icon[293 KB / 8 pages]external icon, Join the Public Health Webinar Series on Blood Disorders. Type II. South Med J 2006;99:36670. This site complies with the HONcode standard for trustworthy health information: verify here. Physical examination findings that may suggest a bleeding disorder include petechiae, ecchymoses, or other evidence of recent bleeding, although absence of these signs does not exclude the possibility of an underlying bleeding condition 7. Advertising revenue supports our not-for-profit mission. 5008 Brittonfield ParkwayEast Syracuse, NY 13057, Upstate Community Hospital4900 Broad RoadSyracuse, NY 13215, 37 West Garden StreetSuite 301Auburn, NY 13021, 5700 West Genesee StreetCamillus, NY 13031, Nurse Practitioners & Physician Assistants, Social Security Disability Benefits With Cancer. Once estrogen levels begin to decrease in the postpartum period, some individuals with bleeding conditions may present with delayed hemorrhage. Von Willebrand disease. What are the Risk Factors with Thrombotic Thrombocytopenic Purpura? What are the Signs and Symptoms of Aplastic Anemia? Drug Saf 2008;31:27582. Genetic tests may be necessary for confirmation of certain von Willebrand disease types 7 10. An accurate diagnosis is extremely important for women in order to avoid unnecessary and/or invasive treatments, such . Boil a handful of crushed fenugreek seeds in water for a couple of minutes before straining the liquid and applying it to your skin using a cotton pad or sponge. Who is at Risk for Disseminated Intravascular Coagulation? A person with VWD is missing one essential blood clotting factor. [, Demers C, Derzko C, David M, Douglas J. Gynaecological and obstetric management of women with inherited bleeding disorders. Before you have any invasive procedure, such as amniocentesis (AM-ne-o-sen-TE-sis), discuss with your doctor whether you need to take steps to prevent serious blood loss. Your doctor will also likely recommend the following blood tests: The results of these tests can fluctuate in the same person over time due to factors such as stress, exercise, infection, pregnancy and medications. See your health care professional if you or someone in your family has these symptoms. For example, garlic supplements can stop platelets from sticking and forming a clot . However, women who have VWD can have bleeding problems during delivery. Avoid eating high-fat fried products. Rick ME. All rights reserved. The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders. We take your privacy seriously. The nutritional value of a salad is lost if you use too much high-calorie dressing, Choose lean meats, skip the cheese, or chose a low-fat cheese if its available. [, Valente MJ, Abramson N. Easy bruisability. See Figure 1 for laboratory tests for suspected bleeding disorders. Connell NT, et al. This tool has been validated in adult women and demonstrates greater than 80% sensitivity and specificity for scores greater than 100 35. Obstet Gynecol 2013;122:136873. ABSTRACT: Von Willebrand disease, the most common inherited bleeding disorder among American women, is a common cause of heavy menstrual bleeding and other bleeding problems in women and adolescent girls. Von Willebrand disease is a common cause of heavy menstrual bleeding and other bleeding problems in women and adolescent girls. Unhealthy food choices and limited physical activity can lead to excess weight gain and obesity for all people. Am J Obstet Gynecol 2009;201:12.e112.e8. Available at: Kingman CE, Kadir RA, Lee CA, Economides DL. ET), James AH. Considering the small number . Blood Advances. In severe cases, heavy bleeding occurs after minor . In this case, Von willebrand disease is pretty rare, but its not a small risk. The study found that people who suffered from volebrand disease were more likely to have a stroke at any given time. Von Willebrand disease is a lifelong bleeding disorder in which your blood doesn't clot properly. Von Willebrand disease (VWD), a congenital bleeding disorder caused by deficient or defective plasma von Willebrand factor (VWF), may only become apparent on hemostatic challenge, and bleeding history may become more apparent with increasing age. Von Willebrand disease is the most common bleeding disorder, and affects males and females equally. Food sources should be safe, but check with your naturopath and avoid supplements that contain garlic or garlic extracts [11 You might need to follow dietary restrictions or fast for 8-10 hours if blood tests are scheduled. You can review and change the way we collect information below. When you have low levels of this protein or it doesn't work as it should, small blood cells called platelets cannot stick together properly nor attach themselves normally to the blood vessel walls when an injury has occurred. Von Willebrand disease and other bleeding disorders in women: consensus on diagnosis and management from an international expert panel. The usual cause of von Willebrand disease is an inherited abnormal gene that controls von Willebrand factor a protein that plays a key role in blood clotting. Accessed Aug. 26, 2021. Summary [, Lee CA. Do you miss school because of your period? Regardless ofyour hemophilia type A, B or C the goal is to keep your joints strong and healthy, and to keep extra weight off to avoid muscle strains and bleeding in vulnerable joints. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. How is Disseminated Intravascular Coagulation Diagnosed? LITTLE RAY OF SUNSHINE. 2006;108(10):3344-3351. Von Willebrand disease is a blood clotting disorder that usually develops from an inherited genetic condition but can in rare cases develop alongside an autoimmune disease or . Von Willebrand disease is the most common bleeding disorder, and affects males and females . Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Von Willebrand disease: Treatment of minor bleeding and routine care. Accessed Aug. 26, 2021. Limited studies have been conducted on the treatment of heavy menstrual bleeding specifically for women with von Willebrand disease or other disorders of hemostasis; the following treatments are based on this evidence and expert opinion. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Obstet Gynecol 2012;120:197206. Accessed Aug. 26, 2021. Von Willebrand disease in women. If you menstruate, how many days do your periods last? Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, DVT (deep vein thrombosis) prevention and treatment. Tell your doctor, dentist, and pharmacist that you have VWD. Limited studies in women with von Willebrand disease and heavy menstrual bleeding suggest these treatments also may be effective for this population 14 16 19 24. Von Willebrand disease, sometimes referred to as vWD, is the most common inherited blood disorder in dogs and in humans, for that matter. Obstetric management of adolescents with bleeding disorders. Von Willebrand disease (VWD) is a blood disorder caused by the lack of a protein known as the Von Willebrand factor (VWF). Von Willebrand factor helps blood cells stick together (clot) when you bleed. Maintaining iron levels is also particularly important for people with hemophilia, as an estimated 0.75 micrograms of iron is lost with each 15 ml of blood. Antifibrinolytic medications reduce bleeding by stopping a clot from breaking down, which helps prevent excessive bleeding. People with this condition often experience easy bruising, long-lasting nosebleeds, and excessive bleeding or oozing following an injury, surgery, or dental work. Rarely, von Willebrand disease can cause uncontrollable bleeding, which can be life-threatening. Von Willebrand disease (vWD) is a common, inherited, genetically and clinically heterogeneous hemorrhagic disorder caused by a deficiency or dysfunction of the protein termed von Willebrand factor (vWF). Here's some information to help you get ready for your appointment. The first step in the evaluation of women with suspected bleeding disorders involves obtaining a detailed medical history and performing a physical examination 7 10. Mayo Clinic does not endorse companies or products. Who is at Risk for Immune Thrombocytopenia? People with this disease often experience bruising, nosebleeds, and prolonged bleeding or oozing following an injury, affer surgery, or having a tooth pulled. You also may want to tell other people about your condition, like your employee health nurse, gym trainer, and sports coach. 557. What Is Von Willebrand Disease? Type 1. How often do you change your tampon or sanitary pad during a period? Fig. This helps form a clot and stops bleeding. Rick ME. Signs, Symptoms, and Complications of Deep Vein Thrombosis? Obstet Gynecol 2010;116:86575. This content does not have an Arabic version. Von Willebrand disease (VWD) is an inherited disorder that affects the blood's ability to clot. ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease. If your condition is mild, your doctor might recommend treatment only when you're having surgery or dental work or when you've had a trauma, such as a car accident. Over time, people with hemophilia may experience issues with their bone health due to joint bleeds. Pregnancy can be a challenge for women who have VWD. The diagnosis of type 2N should be considered in patients with low FVIII coagulant activity (FVIII:C) and disproportionally higher VWF antigen, especially when they present with an autosomal recessive pattern of inheritance. How is Antiphospholipid Antibody Syndrome Treated? Am J Obstet Gynecol 2008;198:163.e1163.e8. Type 2 VWD: VWF is often in the low or low . Levonorgestrel-releasing intrauterine system compared to low dose combined oral contraceptive pills for idiopathic menorrhagia: a randomized clinical trial [published erratum appears in Contraception 2011;84:112]. 2021; doi:10.1182/bloodadvances.2020003264. All rights reserved. have von Willebrand disease. J Obstet Gynaecol Can 2009;31:3407. This site complies with the HONcode standard for trustworthy health information: verify here. You will be subject to the destination website's privacy policy when you follow the link. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Fertil Steril 2005;84:134551. What are the signs and Symptoms of Fanconi Anemia? 2 People with a bleeding disorder often experience the effects of obesity immediately, as excess weight can limit joint mobility and may lead to more frequent joint . Avoid over-the-counter medicines that can affect blood clotting, including aspirin, . [, Shankar M, Lee CA, Sabin CA, Economides DL, Kadir RA. . Screening women with menorrhagia for underlying bleeding disorders: the utility of the platelet function analyser and bleeding time. But unlike hemophilia, which mainly affects males, von Willebrand disease affects males and females and is usually milder. This content does not have an English version. Once a diagnosis of von Willebrand disease has been established, a multidisciplinary approach to management, which involves obstetriciangynecologists and hematologists, results in optimal treatment outcomes 14. . People with the disease have low levels of von Willebrand factor, a protein that helps blood clot, or the protein doesn't perform as it should. Blood. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, DVT (deep vein thrombosis) prevention and treatment. VWD is an inherited bleeding disorder where the body doesn't produce enough (or in some cases produces faulty) von Willebrand's factor, an essential blood protein for clotting. Who is at Risk for Antiphospholipid Antibody Syndrome? Other Names for Disseminated Intravascular Coagulation. Others, looking at similar sources, report that teenagers and children with hemophilia arealmost twice as likely to be overweight as the general population. Most people with the disease are born with it, having inherited it from one or both parents. [, http://www.nhlbi.nih.gov/guidelines/vwd/vwd.pdf, http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=182&contentid=47&rptname=bleeding, Alliance for Innovation on Women's Health, Postpartum Contraceptive Access Initiative. Certain genetic diseases that affect blood clotting (e.g., hemophilia, von Willebrand disease) or disrupt inflammatory pathways (e.g., atopic dermatitis, psoriasis, rosacea) can significantly decrease the rate of wound healing and remodeling. Excessive bleeding is common during menstruation, post operatively, or after injury. Normally, pieces of blood cells (platelets) clump together after an injury. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Retrieved August 9, 2013. Pensacola, FL 32502 If you have the gene for von Willebrand disease, you have a 50% chance of transmitting this gene to your children. . [, Lethaby A, Farquhar C, Cooke I. Antifibrinolytics for heavy menstrual bleeding. What Causes Disseminated Intravascular Coagulation? A hematologist is a doctor who specializes in diagnosing and treating blood disorders. Signs, Symptoms, and Complications of Pulmonary Embolism, Signs and Symptoms of Sickle Cell Disease, Screening and Prevention of Sickle Cell Disease, Signs, Symptoms, and Complications of Thalassemias, Other Names for Thrombocythemia and Thrombocytosis. This is the most common and mildest form of vWD. Foods to Avoid with Hemophilia. The diagnosis, evaluation, and management of von Willebrand disease. Although recent studies have suggested that interrupting combined hormonal contraceptive therapy for von Willebrand testing may be unnecessary 37, further research in this area is needed. . Obstetric concerns regarding patients with bleeding disorders include spontaneous abortion, mode of delivery, epidural management, operative delivery techniques, and postpartum hemorrhage. Advertising revenue supports our not-for-profit mission. Von Willebrand disease is classified by type: Type I. A study published in the Journal of the American Medical Association found that the risk for a person to have the disease increased six-fold if they had a stroke caused by a nosebleed. You then might be referred to a doctor who specializes in the diagnosis and treatment of bleeding disorders (hematologist). NIH Publication No. Haemophilia 2000;6:6438. [, Ragni MV, Bontempo FA, Hassett AC. Von Willebrand disease. Von Willebrand disease. Von Willebrand disease is named after the doctor first described the condition in the early 20th Century. What Are the Signs and Symptoms of Hemolytic Anemia? You also should meet with an anesthesiologist to review your choices for anesthesia (AN-es-THE-ze-ah) and to discuss taking medicine to reduce your bleeding risk. [, James AH, Kouides PA, Abdul-Kadir R, Edlund M, Federici AB, Halimeh S, et al. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. NIH Publication No. [, Management of abnormal uterine bleeding associated with ovulatory dysfunction. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Write for us Personal Care, Skin Care, Spa, Lifestyle, Beauty. Von Willebrand disease: Treatment of major bleeding and major surgery. The main nutrients involved in redblood cell production are iron, protein, copper, vitamin C, vitamin B12, vitamin B6 and folic acid vitamin E is also involved in red blood cell production, but it can increase the risk of bleeding in high doses. Its one of the most common types of hemorrhagic stroke, and it can be deadly. It does not provide medical advice, diagnosis or treatment. Reaffirmed 2021). Data from Kouides PA, Conard J, Peyvandi F, Lukes A, Kadir R. Hemostasis and menstruation: appropriate investigation for underlying disorders of hemostasis in women with excessive menstrual bleeding. Avoid high-fat condiments like mayonnaise or ketchup choose mustard instead, which is low in calories; Choose salad dressing on the side this way you can control the amount you use. The term "anesthesia" refers to a loss of feeling and awareness. [, Chi C, Pollard D, Tuddenham EG, Kadir RA. Antifibrinolytic agents, such as tranexamic acid and e-aminocaproic acid, can be effective nonhormonal treatment options for adolescents; however, their use in individuals younger than 18 years is considered off-label. As with the adult patient, a multidisciplinary approach to management, which involves both obstetriciangynecologists and hematologists, results in optimal treatment outcomes. One of the most common ways to prevent it is through food. During your third trimester, you should have blood tests to measure von Willebrand factor and factor VIII to help plan for delivery. For example, the school nurse, teacher, daycare provider, coach, or any leader of afterschool activities should know, especially if your child has severe VWD. Screening and Prevention of Thrombotic Thrombocytopenic Purpura, Signs, Symptoms, and Complications of Thrombotic Thrombocytopenic Purpura, Diagnosing Thrombotic Thrombocytopenic Purpura, Treatment of Thrombotic Thrombocytopenic Purpura, Living with Thrombotic Thrombocytopenic Purpura, Signs, Symptoms, and Complications of Von Willebrand Disease, Your Rights and Protections Against Surprise Medical Bills. My 4 year old son was diagnosed with severe type 2a last year after an extreme series of nose bleeds. Clinical presentation and diagnosis of von Willebrand disease. Saving Lives, Protecting People, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, U.S. Department of Health & Human Services. Skip to main content. [, The initial reproductive health visit. Consequently, defective vWF interaction between platelets and the vessel wall impairs primary hemostasis. It is normal for patients, their families, and caregivers to experience a variety of stresses that may change over time. Fertil Steril 2005;84:134551. Clinical characteristics: Von Willebrand disease (VWD), a congenital bleeding disorder caused by deficient or defective plasma von Willebrand factor (VWF), may only become apparent on hemostatic challenge, and bleeding history may become more apparent with increasing age. Primary navigation. If a patients medical history is suggestive of an underlying bleeding condition, specific tests for von Willebrand disease may be indicated, including von Willebrand-ristocetin cofactor activity, vWF antigen, and factor VIII Figure 1 7 10 11. American College of Obstetricians and Gynecologists. An obstetrician is a doctor who provides treatment and care for pregnant women. This glycoprotein can be found in the blood and is essential for the coagulation of wounds and lesions. 9 Foods to Avoid with Diabetes Data from National Heart, Lung, and Blood Institute. Make a donation. Symptoms include easy bruising, frequent and severe nosebleeds, and heavy menstrual cycles. The combination of a pictorial bleeding assessment score greater than 185 and at least one question with a positive result on the screening questionnaire increased the sensitivity to 95% for the diagnosis of an underlying bleeding disorder and 91% for von Willebrand disease; the positive predictive value was 71% and 5%, respectively 36. American College of Obstetricians and Gynecologists. Several factors can disrupt any of the four stages of wound healing. living with von Willebrand disease may mean they should: Avoid activities where they may get hurt, like contact sports such as football . or call toll-free from U.S.: (800) 762-2264 or (240) 547-2156 There are three main types of the disease. Available at: http://www.nhlbi.nih.gov/guidelines/vwd/vwd.pdf . This medication is available as an injection (DDAVP). Von Willebrand disease: Treatment of major bleeding and major surgery . This content does not have an English version. Bethesda (MD): NHLBI; 2007. Have you had anemia or needed a blood transfusion? [, Irvine GA, Campbell-Brown MB, Lumsden MA, Heikkila A,Walker JJ, CameronIT . These changes include: The key is to be realistic and not to set your goals too high. If the heavy bleeding is attributed solely to immaturity of the hypothalamicpituitary axis, an underlying bleeding disorder may be overlooked. Parents pass the gene for the disease to their children. Patients with an underlying bleeding disorder are at a high risk of epidural or spinal hematoma 31. Iron-rich foods include liver, lean red meat, poultry, leafy green vegetables, broccoli, dried beans, grains, and raisins. Many of them affect clotting. The onset of heavy menses at menarche is often the first sign of von Willebrand disease. Factor VIII is involved in another inherited clotting disorder called hemophilia. It can be used before minor surgical procedures to help control bleeding. Iron-rich foods include liver, lean red meat, poultry, leafy green vegetables, broccoli, dried beans, grains, and raisins. Overall, a conclusion that is hard to avoid is that while most of the Type 2 variants and Type 3 VWD are relatively easy to diagnose, the diagnostic certainty for Type 1 disease often remains problematic and may be inherently impossible to simplify. Von willebrand is also known as croup-like nosebleeds and people who have it can experience a blood clot that forms in the nose. Multisite management study of menorrhagia with abnormal laboratory haemostasis: a prospective crossover study of intranasal desmopressin and oral tranexamic acid. The amount of bleeding and need for treatments varies widely from person to person, with some never . Among women with heavy menstrual bleeding, von Willebrand disease appears to be more prevalent among Caucasians (15.9%) than African Americans (1.3%) 3 4. Von Willebrand disease (vWD) is a hereditary bleeding disorder that is characterized by a deficiency of von Willebrand factor, a specific protein needed to help clot blood.Sometimes called pseudohemophilia, vWD is the most common inherited bleeding disorder in both dogs and humans. What are the possible side effects of the medications you're prescribing? In adolescents, however, there often is no previous challenge to the hemostatic system. Have you had blood in your stool that wasn't explained by a known medical problem, such as a stomach ulcer or colon polyp? [, Fraser IS, Porte RJ, Kouides PA, Lukes AS. To evaluate you for von Willebrand disease, your doctor will likely ask you detailed questions about your medical history and check for bruises or other signs of recent bleeding. https://www.uptodate.com/contents/search. From the National Heart Lung and Blood Institute, National Institutes of Health. Development of a screening tool for identifying women with menorrhagia for hemostatic evaluation. Obesity is a worseningproblem in the hemophilia patient community, as it is in the population at large, with obesity rates tripling from 1980 to 2008 among all children, according to the Centers for Disease Control and Prevention. Individuals who live with a rare disease can face challenges that can be overwhelming. blood in the urine from bleeding into the kidneys or bladder. What are the Risk Factors in Thrombocythemia and Thrombocytosis? Many resources exist for patients and health care providers through the National Heart, Lung, and Blood Institute; National Hemophilia Foundation; and the American Society of Hematology. Von Willebrand disease: Treatment of major bleeding and major surgery. Therapies generally prescribed in conjunction with a hematologist once a diagnosis of von Willebrand disease is established include desmopressin acetate, recombinant factor VIII, and vWF complex infusion 7 10. The overall prevalence is even greater among women with chronic heavy menstrual bleeding, and ranges from 5% to 24% 2 3. Clinical presentation and diagnosis of von Willebrand disease. It can sometimes be difficult to stick to your plans when you are eating eat out, but there are ways to avoid overeating orchoosing a meal that might not be good for you. What Is Von Willebrand Disease? This, along with the fact that it can cause bleeding in the nose and gums and sometimes even in the eyes, makes von willebrand disease foods to avoid one of those health scare foods we always have to have on hand. NationalHeart , Lung, and Blood Institute. Many experts advocate that women with von Willebrand disease may have a vaginal delivery safely, with cesarean delivery reserved for standard indications 7 10. Abnormal uterine bleeding is a commonly reported symptom among women with a diagnosis of von Willebrand disease, with 7492% experiencing heavy menstrual bleeding 5. After testing for Hemophilia, adults are advised to shift to natural or organic healthy fat products like nonfat milk or low-fat cheese because these are rich in vitamins, minerals, and calcium. Specific topics addressed in the report include initial screening, diagnosis, and management for patients with the disorder; along with directions for future research and recommendations for training for health professionals. A link to von willebrand disease foods to avoid is not a nosebleed. In von Willebrand disease, named after the Finnish scientist who discovered it, the blood is missing a key protein that helps it clot. Combining iron-rich foods with good . Studies in women without bleeding disorders demonstrate that tranexamic acid reduces menstrual bleeding by 3055% in women with heavy menstrual bleeding 28 29. Agents/circumstances to avoid: Activities involving a high risk of trauma, particularly head . Theoretically, tranexamic acid also should work in women with von Willebrand disease because it stabilizes clots that have already formed, and clot formation is an essential step in limiting menstrual bleeding. Von Willebrand disease. Am J Obstet Gynecol 2008;198:163.e1163.e8. 128. Thyroid hormones if thyroid dysfunction is found to be a causative factor. Obstetriciangynecologists should include von Willebrand disease and other bleeding disorders in the differential diagnosis when evaluating patients with heavy menstrual bleeding, regardless of age. J Pediatr Adolesc Gynecol 2013;26:13841. Do you have flooding? Von Willebrand disease is a lifelong bleeding disorder in which your blood doesn't clot properly. American College of Obstetricians and Gynecologists. Characterized by abnormally slow coagulation of the blood and spontaneous epistaxis and gingival bleeding caused by a deficiency of a component of factor VIII, von Willebrand Disease is the most common inherited blood coagulation disorder.
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