Guidance on the diagnosis and management of platelet-type von Willebrand disease: A communication from the Platelet Physiology Subcommittee of the ISTH

J Thromb Haemost. 2020 Aug;18(8):1855-1858. doi: 10.1111/jth.14827.

Abstract

Platelet-type von Willebrand disease (PT-VWD) is a rare autosomal dominant platelet bleeding disorder, with 55 patients reported worldwide so far, probably frequently misdiagnosed. Currently, there are no clear guidelines for the diagnosis and management of PT-VWD and this may contribute to misdiagnosis and thus to inappropriate treatment of these patients. This report provides expert opinion-based consensus recommendations for the standardized diagnostic and management approach to PT-VWD. Tests essential in the diagnostic workup are platelet count and size, ristocetin-induced platelet agglutination with mixing studies, and sequencing of platelet GP1BA gene. Platelet transfusions and von Willebrand factor-rich concentrates (if VWF is low) are the most effective treatments. This consensus may help to avoid misdiagnosis and guide appropriate management of patients with this disease.

Keywords: GPIb alpha; PT-VWD; macrothrombocytopenia; platelet dysfunction; thrombocytopenia.

MeSH terms

  • Communication
  • Humans
  • Mutation
  • Platelet Glycoprotein GPIb-IX Complex* / genetics
  • von Willebrand Diseases* / diagnosis
  • von Willebrand Diseases* / therapy
  • von Willebrand Factor / genetics

Substances

  • Platelet Glycoprotein GPIb-IX Complex
  • von Willebrand Factor

Supplementary concepts

  • Von Willebrand disease, platelet type