Management of inherited von Willebrand disease in 2007

Augusto B. Federici, Pier Mannuccio Mannucci

Research output: Contribution to journalArticlepeer-review

Abstract

Von Willebrand disease (VWD) is the most frequent inherited bleeding disorder and is due to quantitative (types 1 and 3) or qualitative (type 2) defects of von Willebrand factor (VWF). VWD is inherited by autosomal dominant or recessive patterns, but women with mild forms are more symptomatic. VWD is classified in six VWD types (1, 2A, 2B, 2M, 2N, 3) with peculiar phenotype and genotype. The ristocetin cofactor activity (VWF:RCo) is the most useful test for VWD diagnosis, because it can mimic the interactions of VWF with its platelet receptor. Knowledge of the segments of VWF involved in the binding to its receptor and to factor VIII prompted the search for mutations in specific exons of the VWF gene, with mutations causing VWD types 2A, 2B, 2M, 2N localized in exons 18-28. In case of VWD types 1 and 3 the mutations are spread within the entire gene. Desmopressin (DDAVP) is the treatment of choice for type 1 VWD because it can induce release of normal VWF from cellular compartments. In type 3 and in severe forms of types 1 and 2 VWD, DDAVP is not effective and plasma virally inactivated VWF concentrates should be used in bleedings, surgery, and secondary long-term prophylaxis.

Original languageEnglish
Pages (from-to)346-358
Number of pages13
JournalAnnals of Medicine
Volume39
Issue number5
DOIs
Publication statusPublished - 2007

Keywords

  • Bleedings
  • Desmopressin
  • Genotype
  • Molecular and prenatal diagnosis
  • Phenotype
  • Secondary long-term prophylaxis
  • Surgery
  • Von Willebrand disease
  • Von Willebrand factor
  • Von Willebrand factor concentrates

ASJC Scopus subject areas

  • Medicine(all)

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