Protocols - Hemorio

CLINICAL DIAGNOSIS:
According to International Society of Thrombosis and Hemostasis (ISTH) the hemorrhagic events that may
suggest the presence of VWD are:
- Prolonged epistaxis without previous trauma history, which does not stops after 20 minutes with site
compression or which leads to anemia or require blood transfusion. Epistaxis which requires medical
intervention or cauterization must be considered.
- Cutaneous or ecchymosis bleedings which arise from minimum trauma or even without apparent
trauma or which require medical treatment;
- Prolonged bleeding in cutting wounds, with duration equal to or longer than 15 minutes, which require
medical intervention to stop oral bleeding, such as gum hemorrhage, or after dental eruption or cutting
wounds on the lips or tongue, which require medical treatment or which recurs in the 7 subsequent
days;
- GI hemorrhage, which require medical evaluation or which causes anemia, acute or chronic, not
explained by local lesion;
- Prolonged bleeding or recurring after exodontia or surgery, such as tonsillectomy and adenoidectomy,
requiring medical evaluation;
- Menorrhage not associated to uterine problems; this symptom is more significant when the
menorrhage started on menarche, or produces anemia, or require medical treatment;
- Prolonged bleeding of other mucous or skin surfaces, which require medical treatment.
LABORATORIAL DIAGNOSIS:
Test Type 1 Subtype 2A Subtype 2B Suptype 2M Subtype 2N Type 3
FVW:Ag ↓ ↓ ↓ ↓ N ↓↓↓
FVW:RCo ↓ ↓↓ ↓↓ ↓↓ N ↓↓↓
FVIII:C ↓ ↓ or N ↓ or N ↓ or N 5-30 IU/dl 0.05
IU/dl
-0.1
FVW:RCo/
FVW:Ag
>0.7