Von Willebrand Disease in the elderly: clinical perspectives

John Chapin Department of Hematology, Shire, Lexington, MA, USA Abstract: Von Willebrand disease (VWD) is an inherited bleeding disorder that affects up to 1% of the population. In most cases, VWD results from a mutation in the von Willebrand Factor (VWF) gene, which alters the amount and function o...

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Main Author: Chapin J
Format: Article
Language:English
Published: Dove Medical Press 2018-08-01
Series:Clinical Interventions in Aging
Subjects:
Online Access:https://www.dovepress.com/von-willebrand-disease-in-the-elderly-clinical-perspectives-peer-reviewed-article-CIA
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author Chapin J
author_facet Chapin J
author_sort Chapin J
collection DOAJ
description John Chapin Department of Hematology, Shire, Lexington, MA, USA Abstract: Von Willebrand disease (VWD) is an inherited bleeding disorder that affects up to 1% of the population. In most cases, VWD results from a mutation in the von Willebrand Factor (VWF) gene, which alters the amount and function of VWF, a key glycoprotein in both primary and secondary hemostasis. A comprehensive analysis of patients with VWD should include VWF activity, antigen levels, platelet function, and a careful bleeding history. Treatment options include antifibrinolytics, desmopressin, and VWF replacement therapy. VWF levels fluctuate due to age, stress, environmental exposures, and pharmacologic treatment. Treatment guidelines exist to treat and prevent bleeding for patients undergoing surgery and medical procedures, but often these must be reevaluated in the setting of age-related comorbidities including cardiovascular events, venous thrombosis, and malignancy. In addition, many age-related complications are associated with a secondary acquired von Willebrand syndrome (AVWS), including malignancies, hypothyroidism, cardiovascular diseases, and cardiac replacement devices. The current literature is limited by a lack of older patients in clinical trials. Larger studies are needed to determine if age-related comorbidities affect VWD patients at different frequencies than the general elderly population. There is also a significant need for registry-based studies to evaluate many age-related comorbidities in VWD patients. Keywords: von Willebrand disease, acquired von Willebrand syndrome, bleeding disorders, aging
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spelling doaj.art-cbfdef657f834a9cba865c61f6bf9c472022-12-21T19:25:11ZengDove Medical PressClinical Interventions in Aging1178-19982018-08-01Volume 131531154140233Von Willebrand Disease in the elderly: clinical perspectivesChapin JJohn Chapin Department of Hematology, Shire, Lexington, MA, USA Abstract: Von Willebrand disease (VWD) is an inherited bleeding disorder that affects up to 1% of the population. In most cases, VWD results from a mutation in the von Willebrand Factor (VWF) gene, which alters the amount and function of VWF, a key glycoprotein in both primary and secondary hemostasis. A comprehensive analysis of patients with VWD should include VWF activity, antigen levels, platelet function, and a careful bleeding history. Treatment options include antifibrinolytics, desmopressin, and VWF replacement therapy. VWF levels fluctuate due to age, stress, environmental exposures, and pharmacologic treatment. Treatment guidelines exist to treat and prevent bleeding for patients undergoing surgery and medical procedures, but often these must be reevaluated in the setting of age-related comorbidities including cardiovascular events, venous thrombosis, and malignancy. In addition, many age-related complications are associated with a secondary acquired von Willebrand syndrome (AVWS), including malignancies, hypothyroidism, cardiovascular diseases, and cardiac replacement devices. The current literature is limited by a lack of older patients in clinical trials. Larger studies are needed to determine if age-related comorbidities affect VWD patients at different frequencies than the general elderly population. There is also a significant need for registry-based studies to evaluate many age-related comorbidities in VWD patients. Keywords: von Willebrand disease, acquired von Willebrand syndrome, bleeding disorders, aginghttps://www.dovepress.com/von-willebrand-disease-in-the-elderly-clinical-perspectives-peer-reviewed-article-CIAvon Willebrand diseaseacquired von Willebrand syndromebleeding disordersaging
spellingShingle Chapin J
Von Willebrand Disease in the elderly: clinical perspectives
Clinical Interventions in Aging
von Willebrand disease
acquired von Willebrand syndrome
bleeding disorders
aging
title Von Willebrand Disease in the elderly: clinical perspectives
title_full Von Willebrand Disease in the elderly: clinical perspectives
title_fullStr Von Willebrand Disease in the elderly: clinical perspectives
title_full_unstemmed Von Willebrand Disease in the elderly: clinical perspectives
title_short Von Willebrand Disease in the elderly: clinical perspectives
title_sort von willebrand disease in the elderly clinical perspectives
topic von Willebrand disease
acquired von Willebrand syndrome
bleeding disorders
aging
url https://www.dovepress.com/von-willebrand-disease-in-the-elderly-clinical-perspectives-peer-reviewed-article-CIA
work_keys_str_mv AT chapinj vonwillebranddiseaseintheelderlyclinicalperspectives