Von Willebrand Disease (VWD)
Part 2: NHLBI Diagnosis Guidelines

VWD NHLBI Guidelines (2008) "Low VWF" versus "VWD Type 1"

May 2011

This slide summarizes rationale for distinguishing between "low VWF" and "VWD type 1" (as initially elaborated in the cited 2003 article by Sadler). Low VWF is common – for example, using typical 2 SD (standard deviation) reference ranges for VWD laboratory test results, about 2.5% of apparently normal persons would have levels somewhat below the lower level cutoff. Bleeding symptoms are common, even in apparently normal persons, with a prevalence up to 25 to 50% (see Part 1 discussion, slide 16). Therefore, low VWF and bleeding symptoms can be coincidentally associated (possibly as much as 10% or more). Mildly low VWF (just below the reference range) is believed to confer only modest risk of bleeding. Caution is therefore advised in diagnosing type 1 VWD, especially with mildly or borderline low levels, and in the absence of an abnormal bleeding history.

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Jump to section:

• Introduction
• Objectives—Part 2
• VWD NHLBI Guidelines (2008)¹
• VWD Classification — ISTH^1,2
• VWD NHLBI Guidelines (2008) Initial Patient Evaluation — Laboratory¹
• VWD NHLBI Guidelines 2008 Initial Patient Evaluation — Laboratory¹
• VWD — Initial Laboratory Evaluation
• VWD NHLBI Guidelines (2008) Subsequent Patient Evaluation—Laboratory¹
• Additional VWD Testing — Laboratory¹
• VWF Multimer Analysis: Intermediate Resolution³
• VWF Multimer Analysis: Recommendations⁴
• VWF Multimer Analysis: Recommendations⁴
• Expected Laboratory Values in VWD¹
• Typical Patterns of Laboratory Test Results for VWD Diagnosis and Classification¹
• VWD NHLBI Guidelines (2008) "Low VWF" versus "VWD Type 1"
• VWD Diagnosis (Especially Type 1)
• VWD NHLBI Guidelines ABO Blood Group & VWF/VWD^1,5
• VWD NHLBI Guidelines ABO Blood Group and VWF/VWD: Soft Recommendations
• VWD NHLBI Guidelines (2008): Collection and Handling of Samples for Laboratory Testing¹
• VWD NHLBI Guidelines (2008): Collection and Handling of Samples for Laboratory Testing¹
• VWD NHLBI Guidelines (2008): Collection and Handling of Samples for Laboratory Testing¹
• VWD NHLBI Guidelines: Collection and Handling of Samples for Laboratory Testing^1,4
• VWD NHLBI Guidelines (2008) Summary of Laboratory Recommendations
• VWD NHLBI Guidelines (2008) Summary of Laboratory Recommendations
• References
• VWD Profile
• Questions?