Von Willebrand disease: a key to understanding nosebleeds in men: 616.15

Abstract

Summary. Epistaxis represents a significant and persistent challenge in otolaryngology. Spontaneous epistaxis characterized by the absence of obvious causes, presents particular difficulties in diagnosis and treatment. The pathogenesis of epistaxis is significantly influenced by hemostasis disorders. Von Willebrand disease (vWD), which frequently remains undiagnosed and understudied, may play a substantial role in the pathogenesis of spontaneous epistaxis. In women, mild forms of vWD may manifest as heavy menstrual bleeding, while in men the sole symptom may be recurrent epistaxis. A diagnostic error often occurs due to the assumption that arterial hypertension is the underlying cause of epistaxis. Nevertheless, the relationship between epistaxis and arterial hypertension is currently regarded as controversial, and the presence of additional factors unrelated to arterial hypertension is a prerequisite for bleeding to occur. The use of acetylsalicylic acid (ASA) in patients with epistaxis and arterial hypertension may exacerbate the recurrence of epistaxis and worsen the manifestations of bleeding diathesis in patients with coagulopathies. Therefore, when prescribing ASA, it is important to consider the possibility of vWD in patients with recurrent epistaxis.

For citation: Koloskov A.V., Manucharova K.A. Von Willebrand disease: a key to understanding nosebleeds in men. Tromboz, gemostaz i reologiya. 2024;(3):4–12. (In Russ.).

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