This is a Haematology case study of a 14 year old girl with von Willebrand disease, presented by Final Year Medical Laboratory Sciences students [Symon Nayupe, Dokani Ndovi, Vincent Chidya, Yollam Chavula, Juma Kawonga] from University of Malawi's College of Medicine.

1. 14 YEAR OLD GIRL WITH
MENORRHAGIA
Symon Nayupe
Dokani Ndovi
Vincent Chidya
Yollam Chavula
Juma Kawonga

2. The Case
• H:Haem case 3.docx

3. The results
• Low hgb, low MCV
• High platelet count, and high APTT
• However, the patient has WBCs, PT and
Neutrophil and Lmphocytes that are within
the reference range

4. Likely cause of anaemia
• Iron deficiency due to excessive bleeding

5. Possible causes of abnormal
coagulation results
• Deficiency of factors II, V, VIII, IX and XII
• Von willebrand factor deficiency

6. Likely diagnosis
• Von willebrand disease
– an autosomal inherited bleeding disorder
– associated with reduced production of vWF or
production of defective vWF

7. Further investigations
• Von willebrand factor levels
• Bleeding time
• Factor VIII levels

8. Management in case of surgery
• Avoid anti-platelet drugs like aspirin
• Transfusion of factor VIII and von Willebrand
rich concentrates

9. References
• David L. von Willebrand disease: Advances in
Pathogenetic Understanding, diagnosis, and
Therapy. American Society of Haematology.
2013; Bleeding Disorders: 254-260
• Turgeon ML; Clinical Haematology: Theory and
Procedures (5th edi). Lippincott Williams &
Wilkins, Philadelphia, USA (2012)
• Dr Ben Chosamata. Haematology Class notes.
2012.