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Diagnosis and Treatment of von Willebrand Disease

Release Date: January 15, 2008

Expiration Date: January 15, 2009

Estimated time to complete this Activity: 1 hour

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Overview

Considered to be one of the most common inherited bleeding disorders, von Willebrand disease (vWD) is thought to be present in up to 1% to 2% of the population and to occur in all racial groups. Accurate estimates of the prevalence of vWD are hampered by the highly heterogeneous nature and variable expression of the disorder. Diagnosis of vWD remains challenging because traditional screening assays lack sensitivity and specificity, and many noninherited factors, such as age, inflammation, stress, pregnancy, hormonal cycles, thyroid function, and various medications influence assay results. Non-von Willebrand factor (vWF) genetic modifiers, such as the ABO blood group, may also affect theexpression of vWD, and interpretation of the confounding effect of ABO blood group on vWF levels has been the subject of considerable controversy.

This learning activity will provide an overview of the genetics, classification, and clinical manifestations of vWD. The benefits and limitations of available assays to measure the quantity, function, and structure of vWF in plasma are described. The accompanying interactive cases highlight key considerations in the diagnosis and treatment of pediatric patients with vWD.

Target Audience

Diagnosis and Treatment of von Willebrand Disease is intended for residents and fellows in the field of pediatric hematology/oncology; however, physicians and other health care professionals involved in the care and treatment of children with hematologic or oncologic disorders also will benefit from this activity.

Educational Objectives

After completing this continuing medical education (CME) activity, participants should be able to:

• Describe the clinical manifestations of the various types of vWD
• Evaluate the screening assays available for diagnosis of vWD
• Review treatment options for pediatric patients with vWD

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The FCG Institute for Continuing Education and Acumentis. The FCG Institute for Continuing Education is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The FCG Institute for Continuing Education designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity

How to Get Credit

To receive CME Credit, you should read the continuing education information then view and participate by reading the newsletter and working through the interactive cases. Your answers from the test questions posed during the interactive cases will be tallied and a passing score of 70% or higher must be attained to receive credit. You must also complete the online evaluation and credit request form. Then print your certificate online. That's it—no need to wait for the certificate to be mailed to you!

Faculty Disclosure

It is the policy of the FCG Institute for Continuing Education that all faculty participating in continuing medical education activities are expected to disclose to the program audience (1) any real or apparent conflict(s) of interest related to the content of their presentation and (2) discussion of unlabeled or unapproved uses of drugs or medical devices. Faculty disclosure statements can be found with their biographical sketches.

The FCG Institute for Continuing Education and Acumentis Staff Disclosures

The following staff members from both The FCG Institute for Continuing Education and Acumentis who have worked together with the faculty on this educational activity have no financial relationships or affiliations to disclose.

• J. Palmer, PhD
• A. Hosangadi, MS
• L. Ermentrout, MS
• J. Kelly, BS
• M. Francois, BS

Conflict of Interest Resolution

When individuals in a position to control or influence the development of the content have reported Financial Relationships with one or more commercial interests, The FCG Institute for Continuing Education utilizes a process to identify and resolve potential conflicts to ensure that the content presented is free of commercial bias. The content of this presentation was vetted through The Institute’s process of peer review and content validation and modified as required to meet this standard.

Notice About Investigational or Off-Label Use

This educational activity may include discussion of drugs or devices or uses of drugs and devices that have not been approved by the FDA or have been approved by the FDA for specific uses only. It is the responsibility of the physician to determine the FDA clearance status of each drug or device he or she wishes to use in clinical practice. The FCG Institute for Continuing Education is committed to the free exchange of medical education. Inclusion of any product or device discussion, including discussion of investigational or off-label uses, does not imply endorsement by The Institute of the uses, products, or techniques presented.

Disclaimer

This CME/CE activity is designed for use by healthcare professionals for educational purposes only. The information and opinions expressed by the faculty are their own and do not necessarily reflect those of The FCG Institute. The FCG Institute for Continuing Education does not define a standard of care, nor does it intend to dictate an exclusive course of management but presents through the educational activities it sponsors recognized methods and techniques of clinical practice for consideration by physicians and other healthcare providers for incorporation into their practices. Participants should use their own clinical judgment before applying information, whether provided here or by others, for any professional use.

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Sponsored by: The FCG Institute for Continuing Education

The FCG Institute for Continuing Education
gratefully acknowledges an educational grant from
Novo Nordisk Inc. in support of this Web Site