An approach to outreach patients with von Willebrand disease in Egypt by targeting women with heavy menstrual bleeding and/or bleeding symptoms

N. Sherif, H. Goubran, A. Hassan, T. Burnouf, M. El-Ekiaby

Research output: Contribution to journalArticle

Abstract

von Willebrand disease (VWD) is frequently ignored as a cause of menorrhagia. We investigated Egyptian women complaining of heavy menstrual bleeding (HMB) and/or other bleeding symptoms to detect potential VWD cases. Seventy-five female patients complaining of HMB and/or bleeding symptoms and 38 age-matched healthy female controls went through a family history questionnaire, a physical examination and were evaluated for bleeding score, pictorial blood assessment chart (PBAC), complete blood count, serum ferritin, blood group, prothrombin time, activated partial thromboplastin time, factor VIII (FVIII) activity, von Willebrand factor (VWF) ristocetin cofactor (RCo) activity, antigen (Ag), and RCo/Ag ratio. Sixty-eight of 75 patients presented with HMB, out of which 46 had no organic pathology and 7 presented other bleeding symptoms. Six patients were diagnosed with VWD, three with HMB, two with other bleeding symptoms and one with family history of VWD. Two related VWD patients were diagnosed in the control group. There were significant differences in bleeding and PBAC scores, ferritin level, FVIII activity, VWF:RCo and VWF:Ag between VWD patients and controls. This study indicated a high prevalence of VWD among patients with HMB without organic pathology (6.5%) and demonstrated the sensitivity of diagnostic parameters of VWD patients in an outreach campaign. The inexpensive bleeding and PBAC scoring systems are valuable to exclude cases without objective bleeding symptoms. Raising gynaecologists awareness about hereditary bleeding disorders is important to ensure a proper diagnosis and possible referral of these patients. Management of these patients with comprehensive medical care services under a multidisciplinary team would be ideal.

Original languageEnglish
Pages (from-to)238-243
Number of pages6
JournalHaemophilia
Volume20
Issue number2
DOIs
Publication statusPublished - 2014

Fingerprint

von Willebrand Diseases
Egypt
Hemorrhage
von Willebrand Factor
Ferritins
Pathology
Menorrhagia
Antigens
Blood Cell Count
Partial Thromboplastin Time
Prothrombin Time
Blood Group Antigens
Physical Examination

Keywords

  • Bleeding
  • Menorrhagia
  • PBAC
  • Von Willebrand factor

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

Cite this

An approach to outreach patients with von Willebrand disease in Egypt by targeting women with heavy menstrual bleeding and/or bleeding symptoms. / Sherif, N.; Goubran, H.; Hassan, A.; Burnouf, T.; El-Ekiaby, M.

In: Haemophilia, Vol. 20, No. 2, 2014, p. 238-243.

Research output: Contribution to journalArticle

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