Von Willebrand disease
The most common inherited bleeding disorder, caused by a lack or fault of von Willebrand factor — a protein that helps platelets stick and stabilises factor VIII. It causes easy bruising, nosebleeds, heavy periods and prolonged bleeding after surgery, and is usually mild.
What it is
Von Willebrand disease is the most common inherited bleeding disorder, affecting up to about 1 in 100 people, though many have very mild disease. It is caused by a lack, or a fault, of von Willebrand factor — a protein with two jobs in clotting: it helps platelets stick to the wall of an injured blood vessel to form the first plug, and it carries and protects factor VIII (the same factor that is low in hemophilia A). When it is deficient or abnormal, both platelet-type and factor-type bleeding can occur. Most people have the mild type 1 (a partial deficiency); type 2 (the factor works poorly) and the rare, severe type 3 (near-complete absence) are less common. It affects men and women equally, but women often notice it more because of heavy menstrual periods. Typical features are easy bruising, frequent or prolonged nosebleeds, bleeding from the gums, heavy periods, and excessive bleeding after surgery, dental work or childbirth. Diagnosis needs specific tests of von Willebrand factor level and activity, and factor VIII; routine clotting tests may be normal or show a mildly prolonged aPTT. Treatment ranges from medicines that boost the body's own factor (desmopressin) to factor replacement for procedures or severe cases, and most people manage well.
Key lab markers
- von Willebrand factor level and activity — the key diagnostic tests (specialist assays).
- Factor VIII — often reduced, as von Willebrand factor carries it.
- aPTT — may be mildly prolonged or normal.
- Platelet count — usually normal (the platelets are normal in number, but don't stick well).
- PT and fibrinogen — normal.
- Blood count — may show iron-deficiency anaemia from heavy bleeding.
Symptoms
- Easy bruising
- Frequent or prolonged nosebleeds
- Bleeding from the gums
- Heavy or prolonged menstrual periods
- Prolonged bleeding after cuts, surgery, dental work or childbirth
- Blood in urine or stool in more severe cases
- Often a family history of easy bleeding
Related symptoms
Related lab panels
When to discuss with a doctor
Von Willebrand disease is worth considering in someone with a lifelong pattern of easy bruising, frequent nosebleeds, heavy periods, or excessive bleeding after dental work or surgery, especially with a family history — and is diagnosed with specific von Willebrand factor tests arranged by a haematologist. It is particularly important to identify before planned surgery, childbirth or dental procedures, so that steps can be taken to prevent bleeding. People with the condition are usually advised to avoid aspirin and some anti-inflammatory painkillers, which worsen bleeding. Heavy periods that cause iron-deficiency anaemia can be a clue and are treatable. Mediora.AI can help surface a bleeding-tendency pattern — such as iron-deficiency anaemia from heavy bleeding, or a mildly prolonged aPTT — but confirming von Willebrand disease needs specific factor testing and specialist assessment.