By Annette Pinder
Beverly Schaefer, MD is a hematologist at Western New York Blood Care who wants people to know more about blood disorders. According to Dr. Schaefer, “The most common blood disorder that affects one out of every hundred people in the United States is von Willebrand disease (vWD). It is a disorder in which the blood does not clot properly.
“Our blood contains proteins that enable the blood to clot when needed. One of these proteins is von Willebrand factor (vWF). vWD occurs when people have a low level of vWF in their blood or the vWF protein doesn’t work as it should,” explains Dr. Schaefer.
According to the Centers for Disease Control and Prevention (CDC), when a healthy person is injured, the vWF in their blood binds to both blood vessels and small blood cells called platelets, which stick together to form a clot and stop the bleeding. However, when a person has vWD, the clot may take longer to form or form incorrectly, resulting in heavy or prolonged bleeding that is difficult to stop. While rare, it is possible for heavy bleeding to be so significant that it requires blood transfusion, hospitalization, or can even be life-threatening.
Dr. Schaefer explains that there are three types of vWD. Type 1, the most common and mildest form, is characterized by lower levels of vWF. Type 1 is rarely life-threatening, and commonly treated with desmopressin and anti-fibrinolytics (Amicar, Tranexamic acid) for most surgeries, dental procedures, or trauma. In people with Type 2, the amount of vWF is normal but it doesn’t work effectively. Different gene mutations cause subtypes (2A, 2B, 2M and 2N) and each may require different treatment. Type 3, the most severe form of vWD, often requires IV replacement clotting factor.
vWD is typically inherited, and passed down to the children. It occurs in men and women, but women are more likely to notice the symptoms due to heavy or abnormal bleeding during their menstrual periods and after childbirth. Other symptoms include easy bruising, long-lasting nosebleeds, and excessive bleeding or oozing following an injury, surgery, or dental work. Mild forms of the disorder may only become apparent when abnormal bleeding occurs following surgery or a serious injury. It is estimated that 80 percent of women with vWD experience reproductive tract bleeding during pregnancy and childbirth. In severe cases of vWD, heavy bleeding occurs after minor trauma or even in the absence of injury. Symptoms of vWD may change over time.
Determining the presence of the disorder requires a comprehensive physical examination, which includes your family history, including any history of bleeding and unusual bruising. Blood tests determine clotting proteins present in the blood and whether the clotting proteins are working properly. If you think you may have a blood disorder, and would like to be seen at Western New York BloodCare, call 716-896-2470. Learn more at https://wnybloodcare.org.
WNY BloodCare is a not-for-profit New York State licensed diagnostic and treatment center that offers specialized diagnostic and health maintenance services for individuals with blood disorders that require lifelong medical management.