von Willebrand Disease in Hong Kong Chinese Women with Unexplained Menorrhagia

Abstract

Objectives: To study the prevalence of von Willebrand disease in Hong Kong Chinese women with menorrhagia and to evaluate the utility of ‘Standard Bleeding Questionnaire’ for the screening of menorrhagic women for von Willebrand disease.
Methods: Over an 8-month period, prospective data obtained from patients with unexplained menorrhagia recruited during their first gynaecology clinic visit were analysed. All of them were invited to fill in the ‘Standard Bleeding Questionnaire’ by themselves. In the final data analysis, there were 100 eligible patients.
Results: The prevalence of von Willebrand disease in the study population was 6% (type I, n=4; type II, n=2). The sensitivity of the individual questions in the questionnaire ranged from 0 to 100%. Combined analysis of three questions with the most satisfactory results (symptoms affecting daily life, symptoms since menarche, and a history of anaemia) yielded a sensitivity of 83%, specificity of 60%, positive predictive value of 12%, and negative predictive value of 98%.
Conclusion: The prevalence of von Willebrand disease in patients with unexplained menorrhagia was higher than that in the general population. Detailed history taking and use of simple screening questions can help identify this high-risk group for further diagnostic testing of von Willebrand disease.