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Von Willebrand Disease Type 2N


Presentation

  • A 34-year-old woman at the 39th week of her second pregnancy was admitted for an active labor of a single fetus in cephalic presentation. The patient had been diagnosed with type II vWD by a hematologist during her first pregnancy.[ncbi.nlm.nih.gov]
  • The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]
  • In total, 13 new patients with type 2N VWD were identified, four of whom initially presented with normal levels of factor VIII and only… CONTINUE READING[semanticscholar.org]
  • In total, 13 new patients with type 2N VWD were identified, four of whom initially presented with normal levels of factor VIII and only three of whom (i.e. 23%) derived from specific clinical requests for investigation of type 2N VWD.[insights.ovid.com]
Gagging
  • Direct sequencing of the abnormal band showed a G to A substitution at nt 2354, which modifies the encoded aa residue from glycine (GGG) to glutamic acid (GAG) at position 22 of the mature vWF subunit.[bloodjournal.org]
Ulcer
  • Pharmacokinetics and Safety of Optivate and Haemate P in Patients With Von Willebrand Disease Https://clinicaltrials.gov/show/nct02250508, 2014 added to CENTRAL: 2018 Issue 5 Hypermethylation of the promoter region of the E-cadherin gene (CDH1) in sporadic and ulcerative[cochranelibrary.com]

Workup

  • This emphasizes the need for inclusion of the factor VIII binding assay in the diagnostic workup of suspected haemophilia A.[ncbi.nlm.nih.gov]
  • Initial Von Willebrand Disease Assays If the patient has a significant history of mucocutaneous bleeding, VWD assays should be included as part of the initial workup.[arupconsult.com]
  • An initial hemostasis workup often includes a complete blood count and routine coagulation studies including APTT, PT, and fibrinogen.[clinlabnavigator.com]
  • Clinical Testing and Workup Individuals may undergo standard blood screening tests including a complete blood count (CBC), which may be normal or may show microcytic anemia or low platelet count, especially in individuals with VWD type 2B.[rarediseases.org]
Dyslipidemia
  • Issue 12 Embase The influence of I/D polymorphism of the angiotensin I converting enzyme (ACE) gene and 4G/5G polymorphism of plasminogen activator inhibitor (PAI-1) gene promoter on the haemostatic system in patients with essential hypertension and dyslipidemia[cochranelibrary.com]
Colitis
  • Safety of Optivate and Haemate P in Patients With Von Willebrand Disease Https://clinicaltrials.gov/show/nct02250508, 2014 added to CENTRAL: 2018 Issue 5 Hypermethylation of the promoter region of the E-cadherin gene (CDH1) in sporadic and ulcerative colitis[cochranelibrary.com]

Treatment

  • It also reviews the important area of the obstetric and gynecological manifestations of von Willebrand disease, as well as the treatment of acute bleeding.[books.google.de]
  • Other treatments that can reduce symptoms include fibrinolytic inhibitors and hormones for menorrhagia.[researchgate.net]
  • The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]
  • Abstract Type 2N von Willebrand disease (vWD) can be confused with hemophilia A due to decreased factor VIII levels and a bleeding tendency, and differential diagnosis is of importance for providing the optimal treatment and genetic counseling.[synapse.koreamed.org]
  • Abstract Background : Type 2N von Willebrand disease (vWD) can be confused with hemophilia A due to decreased factor VIII levels and a bleeding tendency, and differential diagnosis is of importance for providing the optimal treatment and genetic counseling[annlabmed.org]

Prognosis

  • Prognosis For patients managed within specialized hemostasis and thrombosis hospital centers, the prognosis is favorable, even for those with the most severe forms of the disease.[orpha.net]
  • Bleeding Assessment Tools: Limits and Advantages for the Diagnosis and Prognosis of Inherited Bleeding Disorders. Semin Thromb Hemost . 2016 Jul. 42 (5):463-70. [Medline] . Lavin M, O'Donnell JS. New treatment approaches to von Willebrand disease.[medscape.com]
  • Bleeding Assessment Tools: Limits and Advantages for the Diagnosis and Prognosis of Inherited Bleeding Disorders. Semin Thromb Hemost. 2016 Jul. 42 (5):463-70. Gill JC, Castaman G, Windyga J, Kouides P, Ragni M, Leebeek FW, et al.[labtestsonline.it]
  • Prognosis and patient counseling.[clinicaladvisor.com]
  • […] oral cancer KT Ku, L Wan, HC Peng, MH Tsai, CH Tsai, FJ Tsai Oral oncology, 2005 , 41(5), 497‐502 added to CENTRAL: 2006 Issue 1 PubMed Mutations of the beta myosin heavy chain gene in hypertrophic cardiomyopathy: critical functional sites determine prognosis[cochranelibrary.com]

Etiology

  • Etiology Type 2N VWD is caused by mutations in the VWF gene. Diagnostic methods Diagnosis is confirmed by demonstration of a profound decrease or absence of VWF binding capacity for FVIII.[orpha.net]
  • […] factor VIII has shorter half life and its plasma levels are lower Note: type O patients have lower levels of vWF (75 IU/dl), type AB patients have highest levels (123 IU/dl) ( Blood 1987;69:1691 ); levels increase with age and with acute phase reactions Etiology[pathologyoutlines.com]
  • Causes, etiology and diagnosis of acquired von Willebrand disease: a prospective diagnostic workup to establish the most effective therapeutic strategies.[ncbi.nlm.nih.gov]
  • Causes, etiology and diagnosis of acquired von Willebrand disease: a prospective diagnostic workup to establish the most effective therapeutic strategies. Acta Haematol 2009; 121 : 177–182. 84. Nichols WL, Rick ME, Ortel TL, et al.[nature.com]

Epidemiology

  • A Laboratory Phenotype/Genotype Correlation of 1167 French Patients From 670 Families With von Willebrand Disease: A New Epidemiologic Picture. Medicine (Baltimore) . 2016 Mar. 95 (11):e3038. [Medline] . [Full Text] .[medscape.com]
  • Epidemiology Prevalence is as high as 1-2% in the general population on unselected screening. Worldwide incidence is around 125 per million with between 0.5 and 5 per million being severely affected. Most patients have mild disease.[patient.info]
  • Summary Epidemiology The prevalence of VWD in the general population is estimated at between 0.1 and 1% (including all forms) depending on the study, but the prevalence of symptomatic VWD that requires specific treatment is estimated at between 1/50,000[orpha.net]
  • Two large epidemiologic studies have reported prevalence rates of approximately 1%. 2,3 In these studies, healthy school-aged children were screened and diagnosed with VWD based on low VWF activity, measured as ristocetin cofactor, and a personal and[mdedge.com]
  • Oxford, UK: Blackwell Publishing; von Willebrand disease: epidemiology.2005; pp. 265-71.[panafrican-med-journal.com]
Sex distribution
Age distribution

Pathophysiology

  • Type 2N von Willebrand disease: clinical manifestations, pathophysiology, laboratory diagnosis and molecular biology. Best Pract Res Clin Haematol 2001;14:337–347. 11. Simon D, Roisenberg I.[synapse.koreamed.org]
  • […] low FVIII activity and no prior family history of hemophilia A Evaluation of patients with Type 1 or Types 2A, 2B, or 2M VWD with FVIII activity discordantly-lower than the von Willebrand factor antigen level Clinical Information Discusses physiology, pathophysiology[mayomedicallaboratories.com]
  • […] classification of VWD was updated in 2006 ( Table 1 ). 1 It incorporates important aspects of clinical phenotype, pathophysiological mechanisms, and treatment considerations.[mdedge.com]
  • Clearly organized into procedure- and patient-related sections while offering a balanced combination of pathophysiology and applications, this practical resource integrates technical experience with clinical results.[books.google.ro]

Prevention

  • Preventing bleeding episodes Some medicines affect blood clotting. Speak to a doctor before taking some OTC medications.[medicalnewstoday.com]
  • Other treatments may include factor replacement therapy; drugs that help prevent the breakdown of blood clots; and, for women, hormone therapy such as birth control pills.[hemaware.org]
  • Patients with repeated heavy bleeding are usually started on prophylactic treatment with desmopressin or clotting factor to prevent bleeding.[clinicaladvisor.com]
  • Medicine to help prevent bleeding during labour will be offered if your level is low. You'll probably be advised to give birth in a specialist hospital in case there are any problems.[nhs.uk]

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