Von Willebrand disease - Revision history

Danbot: Add MedicationDose entry (desmopressin) with SMW annotations

2026-03-20T19:02:45Z

Add MedicationDose entry (desmopressin) with SMW annotations

← Revisión anterior		Revisión del 19:02 20 mar 2026
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	==Disposition==		==Disposition==


			==Medication Dosing==
			{{MedicationDose
			\| drug = Desmopressin
			\| dose = 0.3mcg/kg IV (max 20mcg) over 30min
			\| route = IV
			\| context = Raises VWF and factor VIII levels; effective for Type 1 VWD
			\| indication = Von Willebrand disease
			\| population = Adult
			}}

	==See Also==		==See Also==

Elcatracho: /* Clinical Features */

2022-01-07T22:19:39Z

Clinical Features

← Revisión anterior		Revisión del 22:19 7 ene 2022
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	*Skin and mucosal bleeding		*Skin and mucosal bleeding
	**[[Epistaxis]], gingival bleeding, [[vaginal Bleed Non-Pregnant\|menorrhagia]]		**[[Epistaxis]], gingival bleeding, [[vaginal Bleed Non-Pregnant\|menorrhagia]]
	*Hemarthrosis is unusual		*Hemarthrosis is unusual (more common in factor deficiencies)

	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis: /* Management */

2019-10-01T19:35:54Z

Management

← Revisión anterior		Revisión del 19:35 1 oct 2019
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	*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]		*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]

	===[[Humate-p]]===		===[[Humate-P]]===
	''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''		''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''
	*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>		*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>

ClaireLewis at 19:35, 1 October 2019

2019-10-01T19:35:35Z

← Revisión anterior		Revisión del 19:35 1 oct 2019
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	==Clinical Features==		==Clinical Features==
	*Skin and mucosal bleeding		*Skin and mucosal bleeding
	**Epistaxis, gingival bleeding, menorrhagia		**[[Epistaxis]], gingival bleeding, [[vaginal Bleed Non-Pregnant\|menorrhagia]]
	*Hemarthrosis is unusual		*Hemarthrosis is unusual

Línea 23:		Línea 23:

	==Management==		==Management==
	*Avoid ASA, NSAIDs, heparin and coordinate with hematology prior to any invasive or surgical procedures.		*Avoid [[ASA]], [[NSAIDs]], [[heparin]] and coordinate with hematology prior to any invasive or surgical procedures.
	*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]		*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]

	===Humate-p ~~(Wilate)~~===		===[[Humate-p]]===
	''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''		''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''
	*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>		*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>
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	\|}		\|}

	===Platelet transfusion===		===[[Platelet transfusion]]===
	*Consider if replacement therapy instituted and persistent bleeding		*Consider if replacement therapy instituted and persistent bleeding
	===Desmopressin===		===[[Desmopressin]]===
	*Induces release of vWF from endothelial storage sites		*Induces release of vWF from endothelial storage sites
	*0.3mcg/kg IV (max 20mcg) over 30min		*0.3mcg/kg IV (max 20mcg) over 30min

Ostermayer: /* Intermediate-Purity Factor VIII */

2019-05-12T19:30:55Z

Intermediate-Purity Factor VIII

← Revisión anterior		Revisión del 19:30 12 may 2019
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	*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]		*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]

	~~===Intermediate-Purity Factor VIII===~~		===Humate-p (Wilate)===
	====Humate-p (Wilate)====
	''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''		''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''
	*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>		*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>

Ostermayer: /* Humate-p */

2019-05-12T19:25:33Z

Humate-p

← Revisión anterior		Revisión del 19:25 12 may 2019
Línea 27:		Línea 27:

	===Intermediate-Purity Factor VIII===		===Intermediate-Purity Factor VIII===
	====Humate-p====		====Humate-p (Wilate)====
	''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''		''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''
	*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>		*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>

Ostermayer: /* Wilate */

2019-05-12T19:25:14Z

Wilate

← Revisión anterior		Revisión del 19:25 12 may 2019
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	*For severe bleeding the loading dose is increased to 50 to 75 IU/kg		*For severe bleeding the loading dose is increased to 50 to 75 IU/kg

	~~====Wilate====~~
	{\| {{table}}		{\| {{table}}
	\| align="center" style="background:#f0f0f0;"\|'''Type of Hemorrhages/Surgery'''		\| align="center" style="background:#f0f0f0;"\|'''Type of Hemorrhages/Surgery'''

Rossdonaldson1: /* Recombinant Factor VIIa */

2017-06-27T21:03:13Z

Recombinant Factor VIIa

← Revisión anterior		Revisión del 21:03 27 jun 2017
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	\| Type 2 \|\|Abnormal protein \|\|		\| Type 2 \|\|Abnormal protein \|\|
	\|-		\|-
	\| Type 2A \|\|Abnormal protein leading to lower levels of high weight multimers \|\|Desmopressin (only effective in 10%), ~~Humate~~-P		\| Type 2A \|\|Abnormal protein leading to lower levels of high weight multimers \|\|Desmopressin (only effective in 10%), Intermediate-Purity Factor VIII
	\|-		\|-
	\| Type 2B \|\|Abnormal protein with increased binding to gpIIb leading to lower levels of high weight multimers \|\|~~Humate~~-P		\| Type 2B \|\|Abnormal protein with increased binding to gpIIb leading to lower levels of high weight multimers \|\|Intermediate-Purity Factor VIII
	\|-		\|-
	\| Type 2N \|\|Lack of Factor VIII binding site leading to low Factor VIII levels \|\|Desmopressin		\| Type 2N \|\|Lack of Factor VIII binding site leading to low Factor VIII levels \|\|Desmopressin
	\|-		\|-
	\| Type 2M \|\|Abnormal protein but normal multimer size \|\|~~Humate~~-P		\| Type 2M \|\|Abnormal protein but normal multimer size \|\|Intermediate-Purity Factor VIII
	\|-		\|-
	\| Type 3 \|\|No von Willebrand or Factor VIII present \|\|~~Humate~~-P		\| Type 3 \|\|No von Willebrand or Factor VIII present \|\|Intermediate-Purity Factor VIII
	\|-		\|-
	\| Pseudo Von Willebrand (platelet-type) \|\|Abnormal gpIIb leading to lower levels of high molecular weight multimers \|\|Platelets + ~~Humate~~-P, rVIIa		\| Pseudo Von Willebrand (platelet-type) \|\|Abnormal gpIIb leading to lower levels of high molecular weight multimers \|\|Platelets + Intermediate-Purity Factor VIII, rVIIa
	\|-		\|-
	\|}		\|}

Rossdonaldson1: /* Management */

2017-06-27T21:01:43Z

Management

← Revisión anterior		Revisión del 21:01 27 jun 2017
Línea 25:		Línea 25:
	*Avoid ASA, NSAIDs, heparin and coordinate with hematology prior to any invasive or surgical procedures.		*Avoid ASA, NSAIDs, heparin and coordinate with hematology prior to any invasive or surgical procedures.
	*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]		*Multiple therapeutic options exist for prophylaxis or treatment of bleeding. The majority of therapy utilizes Humate-P and/or [[desmopressin]]
	===Humate-p===
			===Intermediate-Purity Factor VIII===
			====Humate-p====
	''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''		''VWF and factor VIII concentration is the first line therapy for vWD bleeding patients. It is contraindicated for any patient with prior history of [[anaphylaxis]] to Humate-p''
	*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>		*Loading dose 40 to 60 IU/kg, then 40 to 50 IU/kg every 8 to 12 hours for 3 days to keep the trough level of VWF:RCo >50%; then 40 to 50 IU/kg daily for a total of up to 7 days of treatment. <ref> Humate-P dosing http://www.humate-p.com/DOCS/HumateP-Dosage-PI.pdf</ref>
	*For severe bleeding the loading dose is increased to 50 to 75 IU/kg		*For severe bleeding the loading dose is increased to 50 to 75 IU/kg

	===~~Intermediate purity factor VIII~~===		====Wilate====
	*Goal ~~to increase~~ VWF activity ~~by 50~~-~~100%~~		{\| {{table}}
	*Initial infusion of 20-40 IU/Kg		\| align="center" style="background:#f0f0f0;"\|'''Type of Hemorrhages/Surgery'''
	*High replacement doses may be indicated in more severe disease		\| align="center" style="background:#f0f0f0;"\|'''Loading Dosage (IU VWF:RCo/ kg BW)'''
			\| align="center" style="background:#f0f0f0;"\|'''Maintenance Dosage (IU VWF:RCo/ kg BW)'''
			\| align="center" style="background:#f0f0f0;"\|'''Therapeutic Goal'''
			\|-
			\| Minor Hemorrhages\|\|20-40 IU/kg\|\|20-30 IU/kg every 12-24 hours\|\|VWF:RCo and FVIII activity trough levels of >30%
			\|-
			\| Major Hemorrhages\|\|40-60 IU/kg\|\|20-40 IU/kg every 12-24 hours\|\|VWF:RCo and FVIII activity trough levels of >50%
			\|-
			\| Minor Surgeries\|\|30-60 IU/kg\|\|15-30 IU/kg or half the loading\|\|VWF:RCo peak level of 50% after loading dose
			\|}

	===Platelet transfusion===		===Platelet transfusion===
	*Consider if replacement therapy instituted and persistent bleeding		*Consider if replacement therapy instituted and persistent bleeding

Rossdonaldson1: /* See Also */

2017-01-22T23:07:50Z

← Revisión anterior		Revisión del 23:07 22 ene 2017
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	\|-		\|-
	\|}		\|}

			==Disposition==

	==See Also==		==See Also==