Von Willebrand disease is a lifelong bleeding disorder in which your blood doesn't clot well. People with the disease have low levels of von Willebrand factor, a protein that helps blood clot, or the protein doesn't perform as it should.
Most people with the disease are born with it, having inherited it from one or both parents. However, warning signs, such as heavy bleeding after a dental procedure, might not show up for years.
Von Willebrand disease can't be cured. But with treatment and self-care, most people with this disease can lead active lives.
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Many people with von Willebrand disease don't know it because the signs are mild or absent. The most common sign of the condition is abnormal bleeding.
There are three main types of the disease. The amount of bleeding varies from one person to another, depending on the type and severity of the disease.
If you have von Willebrand disease, you might have:
- Excessive bleeding from an injury or after surgery or dental work
- Nosebleeds that don't stop within 10 minutes
- Heavy or long menstrual bleeding
- Blood in your urine or stool
- Easy bruising or lumpy bruises
Menstrual signs and symptoms may include:
- Blood clots greater than 1 inch (2.5 centimeters) in diameter in your menstrual flow
- The need to change your menstrual pad or tampon more than once an hour
- The need to use double sanitary protection for menstrual flow
- Symptoms of anemia, including tiredness, fatigue or shortness of breath
When to see a doctor
Contact your doctor if you have bleeding that lasts a long time or is hard to stop.
The usual cause of von Willebrand disease is an inherited abnormal gene that controls von Willebrand factor — a protein that plays a key role in blood clotting.
When you have low levels of this protein or it doesn't work as it should, small blood cells called platelets cannot stick together properly nor attach themselves normally to the blood vessel walls when an injury has occurred. This interferes with the clotting process and can sometimes cause uncontrolled bleeding.
Many people with von Willebrand disease also have low levels of factor VIII, another protein that helps in clotting.
Factor VIII is involved in another inherited clotting disorder called hemophilia. But unlike hemophilia, which mainly affects males, von Willebrand disease affects males and females and is usually milder.
Rarely, von Willebrand disease can develop later in life in people who didn't inherit an abnormal gene from a parent. This is known as acquired von Willebrand syndrome, and it's likely caused by an underlying medical condition.
Autosomal dominant inheritance pattern
In an autosomal dominant disorder, the mutated gene is a dominant gene located on one of the nonsex chromosomes (autosomes). You need only one mutated gene to be affected by this type of disorder. A person with an autosomal dominant disorder — in this case, the father — has a 50% chance of having an affected child with one mutated gene (dominant gene) and a 50% chance of having an unaffected child with two normal genes (recessive genes).
Autosomal recessive inheritance pattern
To have an autosomal recessive disorder, you inherit two mutated genes, one from each parent. These disorders are usually passed on by two carriers. Their health is rarely affected, but they have one mutated gene (recessive gene) and one normal gene (dominant gene) for the condition. Two carriers have a 25% chance of having an unaffected child with two normal genes (left), a 50% chance of having an unaffected child who also is a carrier (middle), and a 25% chance of having an affected child with two recessive genes (right).
The main risk factor for von Willebrand disease is having a family history of it. Parents pass the abnormal gene for the disease to their children. Rarely, the disease skips generations.
The disease is usually an "autosomal dominant inherited" disorder, which means you need an abnormal gene from only one parent to be affected. If you have the gene for von Willebrand disease, you have a 50% chance of transmitting this gene to your children.
The most severe form of the condition is "autosomal recessive," which means both of your parents have to pass an abnormal gene to you.
Rarely, von Willebrand disease can cause uncontrollable bleeding, which can be life-threatening. Other complications of von Willebrand disease can include:
- Anemia. Women who have heavy menstrual bleeding can develop iron deficiency anemia.
- Swelling and pain. This can be a result of abnormal bleeding in the joints or soft tissue.
Because von Willebrand disease is usually an inherited disorder, consider having genetic counseling if you have a family history of this condition and you're planning to have children. If you carry the defective gene for von Willebrand disease, you can pass it on to your offspring, even if you don't have symptoms.
Oct. 24, 2019