{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:55:01Z","timestamp":1791273301101,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Von Willebrand disease (VWD) is not a rare inherited bleeding disorder. However, it is frequently underdiagnosed because early mucocutaneous bleeding manifestations are often attributed to local factors such as inflammation or anatomical abnormalities, leading to delayed recognition of the underlying systemic disease. A 31\u2010year\u2010old Han Chinese female presented with persistent gingival bleeding after routine dental scaling. Her medical history was notable for lifelong recurrent epistaxis and severe intraoperative bleeding during a previous cesarean section, both of which had been attributed to local causes. Her father also had a history of childhood epistaxis. Considering the suggestive personal and family bleeding history, the periodontist suspected an underlying systemic bleeding disorder and referred her to a hematologist. Further laboratory and genetic testing confirmed a diagnosis of type 2M\/2A VWD, a rare and recently defined subtype. This case highlights two important clinical messages. First, clinical practitioners, including dentists, can serve as key first responders in identifying systemic disorders by carefully evaluating bleeding and family histories rather than focusing solely on local oral conditions. Second, a comprehensive, patient\u2010centered diagnostic approach is essential to avoid delayed diagnosis of inherited bleeding disorders such as VWD. This case report emphasizes the important role of non\u2010hematology clinicians in the early diagnosis of rare VWD subtypes.<\/jats:p>","DOI":"10.1002\/ccr3.73384","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:07:51Z","timestamp":1788412071000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Gingival Bleeding After Scaling: A Diagnostic Clue to von Willebrand Disease"],"prefix":"10.1002","volume":"14","author":[{"given":"Huihui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Periodontology, Hospital of Stomatology Wuhan University  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hospital of Stomatology Wuhan University  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengguo","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Hospital of Stomatology Wuhan University  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7366-7665","authenticated-orcid":false,"given":"Shuhuan","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Hospital of Stomatology Wuhan University  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V69.2.454.454"},{"issue":"3","key":"e_1_2_14_3_1","first-page":"95","article-title":"Von Willebrand Disease: One in a Thousand or One in a Million?","volume":"30","author":"Fang Y.","year":"2024","journal-title":"Chinese Journal of Thrombosis and Hemostasis"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14263"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2009.03661.x"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14257"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14043"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2021.07.004"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2019000064"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15247"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.91a.22033"},{"issue":"2","key":"e_1_2_14_12_1","first-page":"609","article-title":"Genetic Determinants of Clinical Variability in\u2002Type\u20022\u2002von\u2002Willebrand\u2002Disease: Bridging Genotype and Phenotype","volume":"111","author":"Seidizadeh O.","year":"2026","journal-title":"Haematologica"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14878"},{"issue":"1","key":"e_1_2_14_14_1","first-page":"1","article-title":"Chinese Guideline on the Diagnosis and Management of von Willebrand Disease (2022)","volume":"43","author":"Thrombosis and Haemostasis Group, Chinese Society of Haematology, Chinese Medical Association","year":"2022","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17-0721"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-019-02814-8"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003265"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2022007216"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtha.2024.03.005"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020010038"},{"key":"e_1_2_14_21_1","doi-asserted-by":"crossref","unstructured":"J.Shelton M.Millions R.Khalife andH. L.Sun \u201cPredictors of Diagnostic Delays and Loss to Follow\u2010Up in Women With von Willebrand Disease: A Single\u2010Center Retrospective Cohort Study \u201d8 no.6(2024):102567 https:\/\/doi.org\/10.1016\/j.rpth.2024.102567.","DOI":"10.1016\/j.rpth.2024.102567"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2026.103359"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.4317\/jced.62620"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2024-008261"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.70275"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14050"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14804"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2024000563"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020003264"},{"issue":"3","key":"e_1_2_14_30_1","first-page":"220","article-title":"Epidemiological, Demographic, and Clinical Characteristics of von Willebrand Disease Patients in Zahedan City, Iran: A Descriptive Study","volume":"18","author":"Naderi M.","year":"2024","journal-title":"International Journal of Hematology\u2010Oncology and Stem Cell Research"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2023.02.023"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000000526"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73384","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73384","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73384","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:39:23Z","timestamp":1791272363000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":31,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ccr3.73384"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73384","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73384"}}