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ASPHO February Case Quiz

Page 1 Questions

How Do You Manage a Newborn with Type 2B Von Willebrand Disease? 
A. Kim Ritchey, MD

Liam is a full-term newborn whose mother has type 2B von Willebrand disease. After birth, he is asymptomatic with no bleeding or apparent bruises, but is found to have a platelet count of 4,000.

Significant Past History

The mother initially was diagnosed with idiopathic thrombocytopenic purpura (ITP) because of persistent thrombocytopenia that worsened during pregnancy. She rarely had significant bleeding, except postpartum.

Liam has twin sisters who were born prematurely and are now 5 years old. One sister had an intracranial hemorrhage at birth. Both sisters run platelet counts in 40,000–60,000 range without significant bleeding problems.

Liam’s maternal grandmother and uncle have a similar clinical and laboratory course as Liam. The uncle never had serious bleeding.
1. What is the appropriate management of Liam?