{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:35:52Z","timestamp":1788568552601,"version":"build-2803163510"},"reference-count":31,"publisher":"American Society of Hematology","issue":"8","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Data on infants and toddlers (ITs) with von Willebrand disease (VWD) are lacking. We used data collected in the US Hemophilia Treatment Center Network (USHTCN) to describe birth characteristics, bleeding episodes, and complications experienced by 105 patients with VWD who were &amp;lt;2 years of age. In 68% of the patients, the reason for diagnostic testing was a family history of a bleeding disorder. The mean age at diagnosis was 7 months, with little variation by sex. Patients with type 2 VWD were diagnosed earlier than those with types 1 or 3 (P = .04), and those with a family history were diagnosed \u223c4 months earlier than those with none (P &amp;lt; .001). Among the patients who experienced a bleeding event (70%), oral mucosa was the most common site of the initial bleeding episode (32%), followed by circumcision-related (12%) and intracranial\/extracranial bleeding (10%). Forty-one percent of the initial bleeding events occurred before 6 months of age, and 68% of them occurred before the age of 1 year. Approximately 5% of the cohort experienced an intracranial hemorrhage; however, none was associated with delivery at birth. Bleeding patterns and rates were similar by sex (P = .40) and VWD type (P = .10). Forty-seven percent were treated with plasma-derived von Willebrand factor VIII concentrates. The results of this study indicate that a high percentage of ITs diagnosed with VWD and receiving care within the multidisciplinary structure of the USHTCN have a family history of VWD. In addition, bleeding events such as circumcision-related, oropharyngeal, and intracranial or extracranial episodes are common and are leading indicators for treatment.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020004141","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T05:11:33Z","timestamp":1618981893000},"page":"2079-2086","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":16,"title":["Characteristics, complications, and sites of bleeding among infants and toddlers less than 2 years of age with VWD"],"prefix":"10.1182","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1637-9663","authenticated-orcid":false,"given":"Brandi","family":"Dupervil","sequence":"first","affiliation":[{"name":"Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karon","family":"Abe","sequence":"additional","affiliation":[{"name":"Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8855-9746","authenticated-orcid":false,"given":"Sarah H.","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"The Abigail Wexner Research Institute, Nationwide Children\u2019s Hospital, Columbus, OH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Oakley","sequence":"additional","affiliation":[{"name":"Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-3184","authenticated-orcid":false,"given":"Roshni","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Centers for Bleeding and Clotting Disorders, Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5665-8958","authenticated-orcid":false,"given":"Courtney D.","family":"Thornburg","sequence":"additional","affiliation":[{"name":"Hemophilia and Thrombosis Treatment Center, Rady Children\u2019s Hospital San Diego, San Diego, CA; and"},{"name":"Department of Pediatrics, UC San Diego School of Medicine, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa R.","family":"Byams","sequence":"additional","affiliation":[{"name":"Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1563-6824","authenticated-orcid":false,"given":"J. 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