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Looking for advice from someone with more hematology experience/knowledge

than me.

I have an 18 yo whose father was diagnosed with von

Willebrand’s disease.

Back in 2004, I did a von Willebrand Factor A which came

back at 18% (normal being 50-150) so I diagnosed her with von

Willebrand’s. Now, she needs her wisdom teeth extracted and mother

thought she might need pretreatment as father got DDAVP before sinus surgery

(IV).

So I decided to do a more comprehensive work-up.

PTT 38.5 (23.7-37.7)

Factor VIII Activity 31% (50-150)

Von Willebrand Factor Activity 52% (50-150)

vWF Antigen 51% (50-150)

vWF Collagen Binding Activity 44% (50-150)

vWF Collagen Binding 0.9 ratio (0.6-5.0)

VWF Miltimers – normal pattern which can be seen in

normal or 1 VW Disease.

So my interpretation is she has mild VW or just low VW

disease, most likely Type 1 and she should be low risk. I don’t

know what Type her father was diagnosed with. The problem is that

she has a Medicaid HMO product for insurance and I have no idea how I would

even get her to a hematologist.

Kathy Saradarian,

MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03,

Practicing since 9/90

Practice Partner

5/03

Low staffing

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