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n CME : Your SA Journal of CPD - Diagnosis and management of von Willebrand disease : main article
- Mild type 1 vWD is common and significantly underdiagnosed.
- A detailed history of mucocutaneous bleeding (epistaxis, mouth, menorrhagia, bruising) since childhood is an essential tool in the diagnosis of vWD.
- In women in whom the tests are not diagnostic the best time to sample blood is during the first week of the menstrual period.
- Aspirin should be avoided in patients with vWD, and NSAIDs prescribed with caution.
- Tranexamic acid is very effective in controlling most minor bleeds as well as menorrhagia (for which the combined oral contraceptive pill is also effective).
- DDAVP should be considered in type 1 disease, but access to the intranasal preparation is limited.
- Patients should be registered with Medic- Alert and the data sent to the South African Haemophilia Register.
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