PMID- 30214173
OWN - NLM
STAT- MEDLINE
DCOM- 20181120
LR  - 20181120
IS  - 1178-1998 (Electronic)
IS  - 1176-9092 (Print)
IS  - 1176-9092 (Linking)
VI  - 13
DP  - 2018
TI  - Von Willebrand disease in the elderly: clinical perspectives.
PG  - 1531-1541
LID - 10.2147/CIA.S136931 [doi]
AB  - Von Willebrand disease (VWD) is an inherited bleeding disorder that affects up to 
      1% of the population. In most cases, VWD results from a mutation in the von 
      Willebrand Factor (VWF) gene, which alters the amount and function of VWF, a key 
      glycoprotein in both primary and secondary hemostasis. A comprehensive analysis 
      of patients with VWD should include VWF activity, antigen levels, platelet 
      function, and a careful bleeding history. Treatment options include 
      antifibrinolytics, desmopressin, and VWF replacement therapy. VWF levels 
      fluctuate due to age, stress, environmental exposures, and pharmacologic 
      treatment. Treatment guidelines exist to treat and prevent bleeding for patients 
      undergoing surgery and medical procedures, but often these must be reevaluated in 
      the setting of age-related comorbidities including cardiovascular events, venous 
      thrombosis, and malignancy. In addition, many age-related complications are 
      associated with a secondary acquired von Willebrand syndrome (AVWS), including 
      malignancies, hypothyroidism, cardiovascular diseases, and cardiac replacement 
      devices. The current literature is limited by a lack of older patients in 
      clinical trials. Larger studies are needed to determine if age-related 
      comorbidities affect VWD patients at different frequencies than the general 
      elderly population. There is also a significant need for registry-based studies 
      to evaluate many age-related comorbidities in VWD patients.
FAU - Chapin, John
AU  - Chapin J
AD  - Department of Hematology, Shire, Lexington, MA, USA, john.chapin@shire.com.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180831
PL  - New Zealand
TA  - Clin Interv Aging
JT  - Clinical interventions in aging
JID - 101273480
RN  - 0 (von Willebrand Factor)
SB  - IM
MH  - Aged
MH  - Global Health
MH  - Humans
MH  - Morbidity
MH  - Survival Rate
MH  - von Willebrand Diseases/blood/*epidemiology
MH  - von Willebrand Factor/*metabolism
PMC - PMC6124462
OTO - NOTNLM
OT  - acquired von Willebrand syndrome
OT  - aging
OT  - bleeding disorders
OT  - von Willebrand disease
COIS- Disclosure The author is an employee and stock holder of Shire. The author 
      reports no other conflicts of interest in this work.
EDAT- 2018/09/15 06:00
MHDA- 2018/11/21 06:00
PMCR- 2018/08/31
CRDT- 2018/09/15 06:00
PHST- 2018/09/15 06:00 [entrez]
PHST- 2018/09/15 06:00 [pubmed]
PHST- 2018/11/21 06:00 [medline]
PHST- 2018/08/31 00:00 [pmc-release]
AID - cia-13-1531 [pii]
AID - 10.2147/CIA.S136931 [doi]
PST - epublish
SO  - Clin Interv Aging. 2018 Aug 31;13:1531-1541. doi: 10.2147/CIA.S136931. 
      eCollection 2018.