Which presentation is typical of von Willebrand disease?

• A. Severe iron deficiency anemia with glossitis
• B. Acute chest pain and left arm numbness
• C. Excessive bleeding from minor injuries; spontaneous nosebleeds; easy bruising; heavy menses; GI bleeding
• D. Recurrent infections and otitis media

Answer: (C)

Von Willebrand disease causes a bleeding tendency because von Willebrand factor is essential for platelet adhesion and also helps stabilize factor VIII. When this factor is deficient or dysfunctional, primary hemostasis is impaired, leading to mucocutaneous bleeding. The classic presentation includes excessive bleeding from minor injuries, spontaneous nosebleeds, easy bruising, heavy menstrual bleeding, and GI bleeding. This matches the described pattern of bleeding from small injuries, frequent epistaxis, easy bruising, menorrhagia, and GI bleeding. The other scenarios reflect iron-deficiency effects, acute coronary symptoms, or recurrent infections rather than a bleeding disorder.