Table 1.
Genotype-phenotype correlations in VWD.
VWD Type |
Mutation Type | Mutation Location | Inheritance Pattern |
Clinical Phenotype | Laboratory Phenotype |
---|---|---|---|---|---|
Type 1 | Missense, nonsense, deletion, insertion, splicing | Throughout VWF gene | Autosomal dominant | Mild-moderate bleeding | Proportionate decrease in VWF:Ag and VWF:RCo |
Type 3 | Missense, nonsense, deletion, insertion, splicing | Throughout VWF gene | Autosomal recessive | Severe mucosal bleeding, may have joint bleeds | Undetectable VWF:Ag and VWF:RCo |
Type 2A | Missense* | VWF A2 domain D1, D2, D′, D3 domains CK domain | Autosomal dominant | Moderately severe | ↓VWF:RCo/VWF:Ag ratio and loss of high molecular weight multimers |
Type 2B | Missense | VWF A1 domain | Autosomal dominant | Moderately severe | ↓VWF:RCo/VWF:Ag ratio and loss of high molecular weight multimers spontaneous platelet binding ± thrombocytopenia |
Type 2M | Missense* | VWF A1 and A3 domains | Autosomal dominant | Moderately severe | ↓VWF:RCo/VWF:Ag ratio and/or collagen binding defect |
Type 2N | Missense* | D′ and D3 domains | Autosomal recessive | Moderately severe | Defect in FVIII binding |
Missense mutations are the most frequent, but deletions, insertions, and splicing mutations have been reported.3