Vwd sentence example

vwd
  • The Finnish physician Erik von Willebrand was the first to describe von Willebrand disease (VWD).
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  • Individuals with VWD, therefore, have difficulty in forming blood clots, and as a result, they may bleed for a longer time.
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  • Approximately one out of 100 people are affected with VWD, making it the most common inherited bleeding disorder.
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  • Approximately 70 to 80 percent of people with VWD have type 1, and close to 20 to 30 percent have type 2.
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  • Type 3 is very rare and occurs in less than 1 percent of people with VWD.
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  • The complex genetics of VWD involve a gene found on chromosome 12.
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  • Most of the vWF gene changes are significant enough that a change in only one vWF gene is sufficient to cause VWD.
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  • However, some types of gene changes only cause VWD if both genes are changed, which often leads to more severe symptoms.
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  • Type 1 VWD is called an autosomal dominant condition since it is caused by a change in only one vWF gene.
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  • Since type 1 VWD results in only a slight decrease in the amount of vWF produced, the symptoms are often mild and not apparent in some individuals.
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  • Most cases of type 2 VWD are autosomal dominant since a change in only one vWF gene results in the production of an abnormal form of vWF.
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  • An autosomal dominant form of VWD can be inherited from either parent or can occur as a spontaneous gene mutation (change) in the embryo that is formed when the egg and sperm cells come together during fertilization.
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  • Some cases of type 2 VWD and all cases of type 3 VWD are autosomal recessive, since they are caused only by changes in both vWF genes.
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  • A person with an autosomal recessive form of VWD has inherited both a changed gene from the mother and a changed gene from the father.
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  • Parents who have a child with an autosomal recessive form of VWD are called carriers, since they each possess at least one changed vWF gene.
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  • Many carriers for the autosomal recessive forms of type 2 VWD and type 3 VWD do not have any symptoms.
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  • Each child born to parents who both have one changed gene has a 25 percent chance of having VWD, a 50 percent chance of being a carrier, and a 25 percent chance of not being and not having VWD disease.
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  • A person with an autosomal dominant form of VWD has a 50 percent chance of passing the changed gene on to his or her children who may or may not have symptoms.
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  • Even children within the same family who are affected with the same type of VWD may exhibit different symptoms.
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  • A child with VWD may exhibit a range of symptoms over the course of his or her lifetime and may experience an improvement in symptoms with age.
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  • Type 1, the mildest form of VWD, is usually associated with easy bruising, recurrent nosebleeds, heavy menstrual periods, and prolonged bleeding after surgeries and invasive work.
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  • Many people with type 1 VWD do not have any noticeable symptoms or only have prolonged bleeding after surgery or significant trauma.
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  • The amount of vWF produced by the body increases during pregnancy, so prolonged bleeding during delivery is uncommon in people with type 1 VWD.
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  • Children with type 2 VWD usually have symptoms from early childhood.
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  • More than 50 percent of women with type 2 VWD experience heavy menstrual periods that may require a blood transfusion.
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  • Some women with type 2 VWD exhibit prolonged bleeding during delivery.
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  • Type 3 VWD can be quite severe and is associated with bruising and bleeding from the mouth, nose, and from the intestinal, genital, and urinary tracts.
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  • Some women with type 3 VWD experience prolonged bleeding during delivery.
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  • Many children with VWD have mild symptoms or symptoms that can be confused with other bleeding disorders, making it difficult for a doctor to diagnose VWD based on clinical symptoms.
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  • Children with type 1 VWD usually have an increased bleeding time, but they may have an intermittently normal time.
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  • Children with type 2 VWD have a prolonged bleeding time and decreased activity of vWF; they may also have decreased amounts of vWF and factor VIII and decreased factor VIII activity.
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  • The activity of vWF is reduced for all types of VWD, making it the most sensitive means of identifying all three types.
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  • Once a person is diagnosed with VWD, further testing such as vWF multimer analysis and ristocetin-induced platelet aggregation (RIPA) should be performed to determine the subtype.
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  • The vWF multimer analysis is able to differentiate children with a structurally normal vWF (Type 1) from children with a structurally abnormal vWF (Type 2) and is often able to identify the subtype of patients with Type 2 VWD.
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  • Children with type 1 VWD usually have normal to decreased RIPA concentrations.
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  • Depending on the subtype, patients with type 2 VWD either have increased or decreased RIPA.
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  • The detection of gene alteration(s) can confirm a diagnosis and can determine the type and subtype of VWD.
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  • Unfortunately many people with VWD possess DNA changes that are not detectable through DNA testing.
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  • A child who has a mother, father, or sibling diagnosed with VWD should undergo biochemical testing for VWD.
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  • If the relative with VWD possesses a detectable gene change, then DNA testing should be considered.
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  • If one parent has been diagnosed with an autosomal dominant form of VWD or both parents are carriers for an autosomal recessive form of VWD, then prenatal testing should be considered.
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  • The type of treatment chosen depends on the type of VWD and a patient's response to a preliminary treatment trial.
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  • Treatment with DDAVP can also be used to treat some people with type 2 VWD.
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  • Patients with type 2B VWD should not be treated with this medication, since DDAVP can induce dangerous platelet clumping.
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  • Type 3 VWD should not be treated with DDAVP, since this medication does not increase the level of vWF in type 3 patients.
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  • Estrogens, such as are found in oral contraceptives, increase the synthesis of vWF and can sometimes be used in the long-term treatment of women with mild to moderate VWD.
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  • Estrogens are also sometimes used before surgery in women with type 1 VWD.
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  • Patients with VWD should avoid taking aspirin, which can increase their susceptibility to bleeding.
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  • Children with severe forms of VWD should avoid activities that increase their risk of injury such as contact sports.
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  • The prognosis for VWD is generally good, and most individuals have a normal lifespan.
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  • If an individual planning to become a parent believes he or she may be a carrier of VWD, genetic counseling is suggested so that options may be explored.
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  • Children with moderate or severe VWD may need to be discouraged from playing contact sports or participating in other activities where injury is likely.
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