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June 19, 1996


Author Affiliations

Wayne State University School of Medicine, Detroit, Mich

JAMA. 1996;275(23):1814-1815. doi:10.1001/jama.1996.03530470042025

Von Willebrand disease (vWD) affects an estimated 1% of the population, yet the condition is undiagnosed in many affected persons. Originally described by the Finnish physician Erik von Willebrand in 1926, this hereditary disorder is characterized by mucous membrane bleeding (epistaxis, gum bleeding, menorrhagia), excessive bleeding from superficial lacerations, surgery, or invasive dental procedures, and easy bruisability. Although inherited as an autosomal dominant trait, vWD presents more problems for young women, who often have excessive menstrual bleeding.

Until recently, the pathogenesis of vWD was poorly understood, available diagnostic tests were controversial and difficult to interpret, and treatment options were limited. Fortunately, this has changed. We have a much clearer understanding of vWD,1-3 better diagnostic tests, and safer, easy-to-use treatment modalities. These developments—especially for treatment—make it imperative that clinicians at least think of the possibility of vWD when seeing and evaluating patients with mucous membrane—type bleeding, with or without excessive