Confusable diagnoses · PANCE / PANRE

Hemophilia A and B vs Von Willebrand Disease

Hemophilia A and B and Von Willebrand Disease are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.

Hemophilia A and B vs Von Willebrand Disease at a glance

  • Hemophilia A and B: X-linked recessive bleeding disorders from factor VIII (A) or factor IX (B) deficiency — joint and deep-tissue bleeding.
  • Von Willebrand Disease: Most common inherited bleeding disorder — quantitative or qualitative defect in von Willebrand factor (vWF) causing mucocutaneous bleeding.
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Side-by-side comparison

FeatureHemophilia A and BVon Willebrand Disease
At a glanceX-linked recessive bleeding disorders from factor VIII (A) or factor IX (B) deficiency — joint and deep-tissue bleeding.Most common inherited bleeding disorder — quantitative or qualitative defect in von Willebrand factor (vWF) causing mucocutaneous bleeding.
Classic presentationMale infant with prolonged bleeding after circumcision; toddler with knee hemarthrosis after minor trauma; X-linked family history.; Hemarthrosis (joint…Adolescent female with heavy menses, recurrent epistaxis, easy bruising, and a family history of bleeding.; Mucocutaneous bleeding: epistaxis (often…
Workup / key labsProlonged PTT correcting with mixing study + reduced factor VIII (hemophilia A) or factor IX (hemophilia B) with normal vWF. Family history and genetic…Personal and/or family bleeding history + reduced vWF antigen and/or activity (typically <30 IU/dL; 30-50 IU/dL suggestive in symptomatic patients). Subtype…
ImagingMRI for joint and muscle bleeding (more sensitive than X-ray for acute hemarthrosis); CT head urgently for any head trauma or neurologic symptoms; Ultrasound…Echocardiogram if Heyde syndrome (acquired vWD + GI bleeding from angiodysplasia + severe AS) suspected; Endoscopy for unexplained GI bleeding (angiodysplasia)
First-line treatmentAcute bleeding: factor replacement — recombinant factor VIII for hemophilia A (e.g., octocog alfa, efmoroctocog alfa [extended half-life]), recombinant factor…Desmopressin (DDAVP) — releases vWF and factor VIII from endothelial stores; first-line for type 1 and most type 2A; IV, intranasal, or SC; CONTRAINDICATED in…

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Educational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.