Our February, 2021 Quick Question was a case study that drew 60 responses. A 25-YO woman who is 1 month post-partum experiences bruising and menorrhagia. She reports that her mother and brother both experience easy bruising and that her own bruising disappeared during her pregnancy. What condition could cause these symptoms?
- Acquired hemophilia: 12% [7]
- Von Willebrand disease: 63% [38]
- Congenital hemophilia A: 15% [9]
- Disseminated intravascular coagulation: 10% [6]
Comments: Of the 4 answers, congenital hemophilia A is the least likely, since hemophilia A and B are sex-linked disorders that rarely associate with bleeding in women. Acquired hemophilia, a rare autoimmune disorder that may appear post-partum, though it more commonly develops in people over 60 and often associated with another immune or neoplastic disorder, is a possibility but is associated with severe anatomic bleeding. DIC is a possibility and should always be considered and ruled out using coagulation and hematologic parameters, but the most likely is the answer most of us chose, von Willebrand disease, which is autosomal and tends to disappear during pregnancy as a response to estrogens. Thank you for participating and please add your comments.
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