Wolfgang Miesbach: The Maastricht Bleeding Cohort and The High Prevalence of BDUC in Women
Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared a post on LinkedIn:
”One of the highlights of the EHA‑SWG Meeting on Bleeding and Platelet Disorders in Florence was the talk by Nienke Meskes on the Maastricht Bleeding Cohort and the high prevalence of bleeding disorder of unknown cause (BDUC) in women.
In 374 adults (83% women, median age ~40 years) with significant bleeding symptoms (median ISTH‑BAT 6), all undergoing standardized ISTH‑BAT scoring and extensive hemostasis testing, a large proportion still received a diagnosis of BDUC rather than a defined mild bleeding disorder.
Among women, BDUC was the most frequent final diagnosis, particularly in those referred from gynecology, and was strongly associated with heavy menstrual bleeding (HMB) and postpartum haemorrhage (PPH), which were significantly more common compared with women with mild bleeding disorders.
These data place BDUC at the broad base of the ‘bleeding disorder pyramid’ – high prevalence but difficult to diagnose – and highlight that current diagnostic strategies may miss sex‑specific bleeding phenotypes and underestimate disease burden in women.”

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