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Wolfgang Miesbach: The Diagnostic Challenge of Bleeding Disorder of Unknown Cause
Wolfgang Miesbach/LinkedIn; Floor Heubel-Moenen/Hemosum
Mar 5, 2026, 14:54

Wolfgang Miesbach: The Diagnostic Challenge of Bleeding Disorder of Unknown Cause

Wolfgang Miesbach, Professor of Medicine at Frankfurt University Hospital, shared a post on LinkedIn:

“Insightful session at EAHAD 2026, Dublin on Bleeding Disorder of Unknown Cause (BDUC) by Floor Heubel-Moenen.

A thought-provoking presentation highlighting how much work still lies ahead.

Many patients referred for bleeding tendency — especially women — still receive no definitive diagnosis despite extensive testing.

BDUC is common and clinically relevant

In the Maastricht Bleeding Cohort, BDUC represented a substantial proportion of diagnoses, particularly among women.

Sex-specific patterns matter

Heavy menstrual bleeding (HMB) and postpartum hemorrhage (PPH) were more frequent in women with BDUC than in those with mild defined bleeding disorders — suggesting potential predictive value.

Limits of current tools
The ISTH-BAT is essential, but has clear limitations:

  • Reduced sensitivity without hemostatic challenges
  • Recall bias
  • Score saturation
  • Limited differentiation between mild bleeding disorders

Diagnosis by exclusion is not enough

Clinically significant bleeding plus normal lab results remains a major challenge.

We need better strategies that capture symptom and sex-specific bleeding phenotypes.”

Wolfgang Miesbach: The Diagnostic Challenge of Bleeding Disorder of Unknown Cause

Find more posts featuring Wolfgang Miesbach on Hemostasis Today.

BDUC Bleeding Disorder of Unknown Cause EAHAD 2026 Floor Heubel-Moenen Health heavy menstrual bleeding Hematology Hemostasis News Hemostasis Today Medicine Postpartum Hemorrhage Wolfgang Miesbach
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