2019
DOI: 10.1182/blood-2018-10-844936
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How I treat low von Willebrand factor levels

Abstract: Partial quantitative deficiency of plasma von Willebrand factor (VWF) is responsible for the majority of cases of von Willebrand disease (VWD), the most common inherited human bleeding disorder. International consensus guidelines recommend that patients with reduced plasma VWF antigen (VWF:Ag) levels and bleeding phenotypes be considered in 2 distinct subsets. First, patients with marked reductions in plasma VWF levels (<30 IU/dL) usually have significant bleeding phenotypes and should be classified wit… Show more

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Cited by 43 publications
(46 citation statements)
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“…Furthermore, antifibrinolytics can be used in patients undergoing surgery to minimise the risk of bleeding and the need for blood transfusions as well as the incidence of thromboembolic events 44 . In patients with VWD, the co‐administration of tranexamic acid (15‐25 mg/kg body weight three times a day) in some settings, such as dental procedures, has been shown to be beneficial at reducing the occurrence of bleeds and need for additional coagulation factor replacement 45 …”
Section: Perioperative Management Of Vwd In Clinical Studiesmentioning
confidence: 99%
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“…Furthermore, antifibrinolytics can be used in patients undergoing surgery to minimise the risk of bleeding and the need for blood transfusions as well as the incidence of thromboembolic events 44 . In patients with VWD, the co‐administration of tranexamic acid (15‐25 mg/kg body weight three times a day) in some settings, such as dental procedures, has been shown to be beneficial at reducing the occurrence of bleeds and need for additional coagulation factor replacement 45 …”
Section: Perioperative Management Of Vwd In Clinical Studiesmentioning
confidence: 99%
“…The surgical management of patients with low VWF levels continues to pose a significant clinical challenge as patients present with variable bleeding phenotypes; treatment should, therefore, also consider personal and family bleeding histories in addition to VWF levels in order to optimise therapy 45 …”
Section: Evidence Gaps In the Perioperative Management Of Patients Wimentioning
confidence: 99%
“…Increases in VWF levels to normal values in patients with low VWF levels enrolled in the Zimmerman Program were reported in 36% of the population, but for most of these patients, bleeding risk was not reduced. 31,[34][35][36] In the low VWF Ireland Cohort study, Lavin et al 27 examined 126 patients, mostly women (n = 112; 89%), with threshold VWF levels. Diagnosis of low VWF levels was based on patient history, which included bleeding history and VWF level of 30 to 50 IU/dl assayed twice (in a 3 -month interval).…”
Section: Von Willebrand Disease Type 1 Vs Threshold Vonmentioning
confidence: 99%
“…In patients with VWF levels of 30 to 50 IU/dl and bleeding history, the predictability of future bleeding is markedly higher, whereas in asymptomatic patients with VWF levels of 30 to 50 IU/dl, the risk of bleeding is considered rather low. 12,31,32 Clinical and laboratory characteristics of low von Willebrand factor Test results from various centers using large cohorts of patients suggest that in patients with VWF levels of 30 to 50 IU/dl, bleeding symptoms and VWF levels are most often The mechanism behind this is not fully understood. This is most likely due to the antigenic determinants of the ABO system (H -antigen) expressed on the N -linked VWF polysaccharide chains.…”
Section: Von Willebrand Disease Type 1 Vs Threshold Vonmentioning
confidence: 99%
“…Las opciones terapéuticas incluyen el uso de desmopresina, que libera FVW endógeno de las células endoteliales y el FVW exógeno de los concentrados derivados de plasma de FVW/ FVIII. Esto logra incrementar los niveles de FVW, por lo que previenen eventos hemorrágicos severos (59).…”
Section: Tratamientounclassified