Recurrent Hemothorax in a Patient with von Willebrand's Disease: Case Report and Literature Review.

Von Willebrand disease (vWD) type 3 is the most severe and rare form of vWD, often underdiagnosed due to clinical overlap with other bleeding disorders such as hemophilia A. We present a unique case of a woman in her thirties with confirmed vWD type 3 who experienced multiple episodes of spontaneous internal bleeding, including recurrent hemoperitoneum and, notably, spontaneous hemothorax-an extremely rare complication in adults. Her prior misdiagnosis delayed appropriate treatment, highlighting the diagnostic complexity of vWD. Laboratory findings revealed undetectable vWF levels and severely reduced factor VIII activity. She was managed conservatively with factor replacement therapy and antifibrinolytics, avoiding invasive procedures. This case brings attention to an unusual bleeding manifestation in vWD and emphasizes the need for heightened clinical suspicion to guide early and accurate diagnosis.