ArticleResearch and practice in thrombosis and haemostasis2021
Elevated von Willebrand factor levels during heavy menstrual bleeding episodes limit the diagnostic utility for von Willebrand disease.
Article in Research and practice in thrombosis and haemostasis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Past, Present, and Future of von Willebrand Disease.Advances in therapy · 2026Pooled it
- Clotting Factor Concentration During Menstrual Phases in Women With and Without Heavy Menstrual Bleeding: A Systematic Review and Meta-Analysis.Haemophilia : the official journal of the World Federation of Hemophilia · 2025Pooled it
- Seventh Åland Island Meeting on von Willebrand Disease.Haemophilia : the official journal of the World Federation of Hemophilia · 2026Article
- von Willebrand disease: an illustrated review.Research and practice in thrombosis and haemostasis · 2026Review
- Evaluation of coagulation disorders and iron deficiency in women with heavy menstrual bleeding.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Diagnosis of von Willebrand disease.Blood advances · 2025Review
- Understanding Acute Heavy Menstrual Bleeding: Insights From an Interdisciplinary Panel.O&G open · 2025Article
- Intraindividual variability of von Willebrand factor and the need for repeated testing.Research and practice in thrombosis and haemostasis · 2025Article
- von Willebrand disease and heavy menstrual bleeding: when and how to test.Hematology. American Society of Hematology. Education Program · 2024Review
- Predictors of diagnostic delays and loss to follow-up in women with von Willebrand disease: a single-center retrospective cohort study.Research and practice in thrombosis and haemostasis · 2024Article
- von Willebrand disease.Nature reviews. Disease primers · 2024Review
- Association between hemoglobin values and VWF assays: a multicenter investigation.Blood advances · 2024Article
- Investigating patients for bleeding disorders when most of the "usual" ones have been ruled out.Research and practice in thrombosis and haemostasis · 2023Article
- Initial von Willebrand factor antigen values in adolescent females predict future values.Haemophilia : the official journal of the World Federation of Hemophilia · 2023Article
- Building the foundation for a community-generated national research blueprint for inherited bleeding disorders: research to advance the health of people with inherited bleeding disorders with the potential to menstruate.Expert review of hematology · 2023Article
- Laboratory-based inequity in thrombosis and hemostasis: review of the evidence.Research and practice in thrombosis and haemostasis · 2023Review
- Diagnostic pitfalls and conundrums in type 1 von Willebrand disease.Hematology. American Society of Hematology. Education Program · 2022Article
- Saddle Pulmonary Embolism in Patients with Cancer in the Era of Incidental Events: Clinical Findings and Outcomes in a Single Centre Cohort.TH open : companion journal to thrombosis and haemostasis · 2022Article
- Health issues in women and girls affected by haemophilia with a focus on nomenclature, heavy menstrual bleeding, and musculoskeletal issues.Haemophilia : the official journal of the World Federation of Hemophilia · 2022Article
- Cryptogenic oozers and bruisers.Hematology. American Society of Hematology. Education Program · 2021Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHeavy menstrual bleeding (HMB) is often the first bleeding symptom for female individuals with inherited bleeding disorders. Guidelines recommend performing the hemostatic evaluation at HMB presentation. Von Willebrand factor (VWF) levels increase with stress, making it unclear if VWF studies during acute bleeding are beneficial in diagnosing von Willebrand disease (VWD).
objectivesTo determine the utility of testing for VWD during acute HMB. PATIENTS/
methodsThis retrospective cohort study evaluated VWF levels of individuals presenting to the emergency department (ED) with HMB from January 1, 2017, to December 31, 2018, after prospective implementation of a clinical practice guideline recommending hemostatic evaluation in the ED. We compared VWF and factor VIII (FVIII) levels between acute presentation and follow-up visit after bleeding resolution. We compared the diagnostic accuracy of initial and follow-up labs.
resultsDuring the study period, 221 individuals were seen in the ED for acute HMB, and 39 had VWD testing at both time points. Median FVIII and VWF levels were higher during acute bleeding than at follow-up. The difference in VWF levels between visits was negligible when initial FVIII value was normal. Overall incidence of VWD was 7.5%; 69% of those with VWD had low VWF levels during acute HMB.
conclusionVWD testing during acute HMB detects the majority of individuals with VWD but also leads to elevated levels of VWF, potentially limiting at the accuracy of diagnostic labs during acute bleeding episodes. Delayed testing until resolution of anemia and active bleeding may provide more accurate diagnostic evaluation for VWD.
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