Abdul Mannan: The Iceberg Below the Surface in Von Willebrand Disease Care
Abdul Mannan, Consultant Hematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn:
“We treat the bleeds. But do we treat the person?
Von Willebrand Disease affects ~1% of the population. That makes it the most common inherited bleeding disorder on the planet.
Yet most consultations focus on one thing: stopping the bleed.
Here’s what we’re missing:
- Iron depletion — ~45% of women with VWD are iron deficient. Not just anemic. Iron deficient. That means fatigue, brain fog and poor quality of life even when the Hb looks ‘fine’.
- Joint damage — Hemarthrosis occurs in 10-25% overall, more in Type 3. Pain, reduced mobility and long-term arthropathy that nobody asked about.
- Bone health — Data suggest higher fracture risk and osteoporosis in VWD cohorts. The VWF-osteoprotegerin (OPG)-RANKL axis maybe involved.
- Mental health — Depression and anxiety are reported more in adolescents with heavy menstrual bleeding. Many women report sexual restrictions. Relationships suffer.
- Reproductive health — Endometriosis, endometrial hyperplasia, miscarriage. These are not ‘extras’. They are part of the disease.
- Socioeconomic cost — Missed school. Missed work. Lower educational attainment.
Caregiving burden falling disproportionately on women.
VWD care is not just stopping bleeds.
It’s preventing iron depletion, pain, disability, mood problems and life disruption.
Next time you see a patient with VWD, ask them:
How’s your energy? Your joints? Your mood? Your periods? Your work?
You might be surprised by the answers.
Because the iceberg below the surface is bigger than the bleed you can see.”
Find more posts on Hemostasis Today.
-
Jul 7, 2026, 06:19Simone Schoenwaelder: Women Are 25% More Likely to Have Their Stroke Misdiagnosed and Here’s Why
-
Jul 7, 2026, 06:12Dhiraj Bhatia: Extremely Happy to Share Our Review on DNA Nanotechnology in Stroke Repair
-
Jul 7, 2026, 06:04Brian A Beh: An Open Letter to Lisa Murphy Honouring the 30 Years of the Stroke Foundation’s Dedication
-
Jul 7, 2026, 05:55Alan Nurden: A Landmark Review Comparing Hemophilia and Hereditary Angioedema
-
Jul 7, 2026, 05:40Andrew Agwunobi: UConn Health is Proud to Advance Stroke Rehabilitation for Veterans
-
Jul 6, 2026, 22:54Louise St. Germain Bannon: I Wanted to Recognize the Incredible Staff Behind ISTH 2026
-
Jul 6, 2026, 21:46Armghan Ans: UPMC Washington Stroke Program Earns AHA Gold Plus Award for 16th Consecutive Year
-
Jul 6, 2026, 20:31Manik Madaan: Master Transfusion Reactions for USMLE In Less Than 60 Seconds
-
Jul 6, 2026, 19:25Ambreen Kashif: Highlighting the Impact of Temporary Donor Deferrals on Donor Retention