Iron deficiency and von Willebrand disease: the relationship and interdisciplinary approach. A review and own data

Iron deficiency conditions are common for clinical practice especially in women of reproductive age. In coagulopathies, chronic blood loss, in particular heavy menstrual bleeding, becomes the main cause of iron deficiency anemia. The most common form of coagulopathy is von Willebrand disease, and if its severe forms are established in childhood, then mild ones can proceed latent for a long time. Iron deficiency not only worsens the quality of life but can also complicate the course of the underlying disease, creating a vicious circle. Management of such patients is a clinical challenge and requires a comprehensive interdisciplinary approach: timely diagnosis, assessment of the volume of blood loss, its correction, selection of the optimal scheme for replenishing iron deficiency and mandatory elimination of the main hemostasis disorder. This article discusses modern principles of diagnosis and therapy of iron deficiency in women with coagulopathies. The patient model for a preventive approach is presented. The basis of therapy in case of persistent excessive blood loss are iron preparations for parenteral administration, in particular, ferric carboxymaltose. The timely administration of adequate doses of a well-tolerated iron preparation, which became possible with the advent of ferric carboxymaltose, makes it possible to prevent severe forms of anemia and improve the patients’ quality of life.