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Symptoms and diagnosis

Many people with VWD have few or no symptoms. People with more serious VWD may have more bleeding problems. Symptoms can also change over time. Sometimes VWD is discovered only when there is heavy bleeding after a serious accident or a dental or surgical procedure.

The main symptoms of VWD are:

  • easy bruising
  • frequent or prolonged nose bleeds
  • bleeding from gums
  • prolonged bleeding from minor cuts
  • heavy or prolonged menstrual bleeding
  • bleeding in the upper and lower gastrointestinal tract
  • prolonged bleeding following injury, surgery, dental work, or childbirth

More women than men show symptoms of VWD. Women with VWD often bleed more or longer than normal with menstruation and following childbirth. Some women with VWD have a lot of menstrual pain or irregular menstruation.

Blood type can play a role. People with Type O blood often have lower levels of VWF than people with Types A, B, and AB. This means people with VWD and Type O blood may have more problems with bleeding.

VWD is not easy to diagnose. People who think they have a bleeding problem should see a hematologist who specializes in bleeding disorders. Proper tests can be done at a bleeding disorders treatment centre. Since the VWF protein has more than one function, more than one lab test should be used to diagnose VWD.

Testing involves measuring a person’s level and activity of VWF, and that of another blood clotting protein, factor VIII (FVIII). Testing is often repeated because a person’s VWF and FVIII levels can vary at different times.

Some of the tests that may be performed include:

Bleeding time 

Measures how long it takes for bleeding to stop

Factor VIII clotting activity

Measures how well factor VIII works

von Willebrand factor antigen

Measures the amount of VWF

Ristocetin co-factor and/or collagen binding activity

Measures how well VWF works

von Willebrand factor multimers

Measures how the individual molecules of VWF come together (groups of VWF molecules are called multimers) and break apart

Platelet function tests
(e.g. PFA*-100)

*platelet function analyser

Measure how well platelets work