Von Willebrand

Friday, November 19, 2010

VWD von Willebrand referred to is second only to the most common hemophilia hereditary hemorrhagic disease. Childhood that is characterized by hemorrhagic tendency, prolonged bleeding time and factor Ⅷ content reduced. VWD is the lack of high molecular weight factor Ⅷ part, that Ⅷ R due. 1 Ⅷ R is autosomal, and Ⅷ: C is the X chromosome inherited.

Typical VWD only factor Ⅷ related antigen (Ⅷ R: Ag) that Ⅷ R antigen part of the activity decreased, and the factor Ⅷ Rui Situo enzyme cofactor (Ⅷ R: RCOF) reduced or lack of, and Ⅷ: C also reduced, but the extent as severe hemophilia. Ⅷ R: Ag and Ⅷ R: RCOF is between platelets and vascular endothelial and platelet adhesion between the important factor, is induced platelet aggregation from Rui Situo enzyme cofactor, since the lack of von Willebrand The factors that platelet adhesion and aggregation function has obstacles, prolonged bleeding time.

Von Willebrand mode of inheritance is autosomal dominant inheritance, individual subtypes of recessive inheritance. Incidence of both men and women, parents can pass, and some parents may be no bleeding patients. Von Willebrand more bleeding tendency in childhood, adulthood, only a small number of patients to clinical symptoms. Von Willebrand typical symptoms of bleeding in hemophilia similar, but lesser extent, but there are more serious. Condition can be mitigated with age.

Von Willebrand medicine is a "hyperlipidemia" Consumption "category. Its pathogenesis and hemophilia similar.

[Clinical manifestations of von Willebrand]
1. Have a family history: in line with autosomal dominant inheritance, which both men and women to the disease, both parents can be inherited. 2. Hemorrhagic tendency: a mucous membrane, subcutaneous bleeding, or menorrhagia, severe bleeding after surgery with or without history of a small number of joint, muscle bleeding, but generally no joint deformity.

[Von Willebrand diagnosis is based on]
(A) with or without family history, have a family history consistent with autosomal dominant or recessive inheritance.
(B) clinical there mucosa, skin, visceral bleeding, or menorrhagia history of trauma, surgery with or without abnormal bleeding history, a small number of patients can the relevant section of cavity, muscle or other parts of the bleeding.
(C) of the laboratory examination can help diagnose
1. Platelet morphology and count properly.
2. Prolonged bleeding or aspirin tolerance test was positive.
3. Platelet adhesion test extended or normal.
4. Activated partial thromboplastin time prolonged or normal.
5.vWF factor antigen (vWF: Ag) to reduce or normal.
6. Ⅷ coagulation factor activity (Ⅷ: C) reduced or normal.
7. Must exclude platelet dysfunction disease.

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