A 40-year-old woman has easy bruising and decreased Factor VIII levels. What is the most likely diagnosis?

The diagnosis of von Willebrand disease is the most likely in this case due to the combination of easy bruising and decreased Factor VIII levels. This condition is characterized by a deficiency or dysfunction of von Willebrand factor, which is crucial for platelet adhesion and clotting. While Factor VIII, which is deficient in Hemophilia A, is a specific clotting factor that works in the coagulation cascade, von Willebrand factor plays a key role in stabilizing Factor VIII in circulation.

In von Willebrand disease, it's common to see a reduction in Factor VIII levels due to its shorter half-life when not bound to von Willebrand factor. Therefore, patients often present with symptoms related to both bleeding and bruising, similar to what is seen in the scenario of the 40-year-old woman.

The other conditions listed do not align with this presentation. Immune thrombocytopenic purpura primarily affects platelet counts rather than causing decreased Factor VIII. Hemophilia A would typically present with severely low Factor VIII levels and less likely to cause easy bruising without significant bleeding episodes associated with trauma. Thrombotic thrombocytopenic purpura involves a microangiopathic hemolytic anemia and thrombocytopenia, which does not match the