Differential Diagnosis for 19 YOF with Easy Bruising and Elevated von Willebrand Antigen
- Single Most Likely Diagnosis
- Von Willebrand Disease (VWD): This is the most likely diagnosis given the patient's symptoms of easy bruising and elevated von Willebrand antigen levels. VWD is a common bleeding disorder caused by a deficiency or dysfunction of von Willebrand factor, which is crucial for platelet adhesion and protection of factor VIII.
- Other Likely Diagnoses
- Immune Thrombocytopenic Purpura (ITP): Although ITP primarily presents with low platelet counts, some patients may have normal or slightly elevated platelet counts, and easy bruising can be a symptom. However, the elevated von Willebrand antigen might not directly correlate with ITP.
- Platelet Function Disorders: Disorders affecting platelet function, such as Bernard-Soulier syndrome or platelet storage pool defects, can cause easy bruising. The elevated von Willebrand antigen could be secondary or coincidental.
- Do Not Miss Diagnoses
- Hemophilia A or B (Carriers): Female carriers of hemophilia A or B can have mild symptoms due to lyonization (X-chromosome inactivation), including easy bruising. Although less common, this diagnosis is critical due to the potential for severe bleeding during surgeries or trauma.
- Thrombotic Thrombocytopenic Purpura (TTP): TTP is a rare disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, renal failure, and neurological symptoms. Easy bruising can be an initial symptom, and while von Willebrand antigen levels might not directly point to TTP, the condition's severity warrants consideration.
- Rare Diagnoses
- Acquired von Willebrand Syndrome: This condition can occur due to various underlying diseases (e.g., lymphoproliferative disorders, cardiovascular diseases) or medications, leading to the destruction or inhibition of von Willebrand factor.
- Ehlers-Danlos Syndrome: A group of genetic disorders affecting connective tissue, which can lead to easy bruising among other symptoms like hypermobile joints and skin hyperextensibility. The elevated von Willebrand antigen might not be directly related but could be part of a broader vascular or connective tissue disorder.