Symptoms and family history
Common symptoms include heavy or prolonged menstrual bleeding, frequent nosebleeds, easy bruising, bleeding after dental extraction or surgery, and bleeding after childbirth. Symptoms may be mild and can vary over time.
A family history of bleeding is important, but its absence does not exclude the diagnosis. Iron deficiency from heavy periods is a common clue.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
Diagnosis
Testing usually includes von Willebrand factor antigen and activity, factor VIII level and a full blood count. Repeat testing and multimer analysis may be needed because levels fluctuate with stress, pregnancy, inflammation and blood group.
The type of von Willebrand disease matters: type 1 is quantitative, type 2 is qualitative and type 3 is severe. Distinguishing it from haemophilia and platelet disorders guides treatment.
- von Willebrand factor antigen and activity
- Factor VIII level
- Blood count and iron studies
- Multimer analysis when type 2 is suspected
Treatment and procedure planning
Treatment may include desmopressin for selected type 1 patients, von Willebrand factor-containing concentrates, tranexamic acid and hormonal management of heavy periods. The choice depends on the type, severity and procedure.
Dental work, surgery and childbirth need advance planning with the haematology team. Patients should tell dentists and surgeons about the diagnosis and avoid medicines that increase bleeding unless advised.
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, marrow, flow cytometry and molecular reports.