Summer.Thunder
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how can you tell the differences between those two physically without doing any tests? is it possible?
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| antidepressant
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yes, hemophilia is only coagulation problem, vWF disease is both platelet and coagulation problem. Platelet problem (epistaxis, echymoses, petechia, bleeding from superficial scratches) vs coagulation problem (late re-bleed, Menorrhagia, GI bleeds, hemarthroses).
besides that, hemophilia is an X linked recessive disease, therefore males get the disease, where as vWF diease is Autosomal dominant, and only one of the parents have to have the abnormality and 50% of the kids will have the disease. (reading this from Goljan, now)
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| antidepressant
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Factor VIII molecule has 3 parts, vWE, factor VIII coagulant and factor VIII antigen. In vWF diease all of these will be decreased, and due to vWF, we will see platelet adhesion defect, and due to factor VIII coagulant we will see coagulation problem. But hemophilia has only factor VIII coagulant deficiency.
by the way, GI bleed and menorrhagia can be seen in platelet disorder too.
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| Summer.Thunder
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yes, that is very detailed.
but i want to know about the physical symptoms or signs, so when a patient comes in, and you can probably tell which disease s/he has just by observing.
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| antidepressant
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why not petechie, can you not see patient has pin point bleeding in the skin. or if patient doesnt come wtih bleeding from nose, and its not stopping?
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| 1.ammara
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antidepressant wrote:
why not petechie, can you not see patient has pin point bleeding in the skin. or if patient doesnt come wtih bleeding from nose, and its not stopping?
Petechiae are characteristically absent in Hemophilia but present in VW disease.
Clinically, the pt of VW diease presents with spontaneous bleeding from the mucous membranes, excessive bleeding from the wounds, menorrhagia, etc.
and the pt of Hemophilia presents with tendency towards easy bruising and massive hemorrhage after trauma or surgical procedures. in addition, there is often "spontaneous" bleeding in those parts of body whic hare subjected to trauma e.g in joints.
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| antidepressant
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yes,ammara but i am not talking about hemophilia, i was talking about platelet problem, what we see in vWE disease, but summer thunder doesnt want history, he want clinical sign or symptoms. thats why i am saying what if patient comes with petechie, you can see, or epistaxis in vWF, not just history. But hemophilia, i dont know if patient will give history or symptoms, like if he comes with hemarthroses,
late rebleed we can see only if patient went through surgery. anyway.
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| 1.ammara
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antidepressant wrote:
late rebleed we can see only if patient went through surgery. anyway.
ohh yes, but its not only surgery. many a times, patient is intelligent enough to give you the history of prolonged bleeding with "minor" trauma. aint it? thats a different story though,just mentioned it by the way, okay. you are right about the symptoms!
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