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Type 1 <jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content> represents the majority of cases and results from a partial quantitative deficiency of von Willebrand factor (<jats:styled-content style=\"fixed-case\">VWF<\/jats:styled-content>). The diagnosis of Type 1 <jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content> presents many challenges, despite there being three established diagnostic criteria: a personal history of mucocutaneous bleeding, a family history and low <jats:styled-content style=\"fixed-case\">VWF<\/jats:styled-content> levels. These criteria do not always coexist, and there is great overlap of clinical phenotypes and laboratory parameters between healthy individuals and those with <jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content>. Mild bleeding symptoms can have any number of causes and bleeding is commonly reported in the general population. <jats:styled-content style=\"fixed-case\">VWF<\/jats:styled-content> levels do not always correlate with bleeding symptoms and can be variable between affected family members. Additionally, <jats:styled-content style=\"fixed-case\">VWF<\/jats:styled-content> levels vary widely as a result of both genetic and non\u2010genetic influences. Perhaps the greatest current controversy in the diagnosis of Type 1 <jats:styled-content style=\"fixed-case\">VWD<\/jats:styled-content> is that there is no consensus laboratory cut\u2010off for the diagnosis, raising concern about both over\u2010 and under\u2010diagnosis. Ongoing studies are addressing these issues by clarifying the underlying pathogenesis of the disease, as well as the natural history and the risk of future bleeding in those with the diagnosis.<\/jats:p>","DOI":"10.1111\/ijlh.12653","type":"journal-article","created":{"date-parts":[[2017,4,27]],"date-time":"2017-04-27T01:40:49Z","timestamp":1493257249000},"page":"61-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Controversies in the diagnosis of Type 1 von Willebrand disease"],"prefix":"10.1111","volume":"39","author":[{"given":"M. L.","family":"Bowman","sequence":"first","affiliation":[{"name":"Department of Medicine Queen's University  Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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