Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect.
We describe a man with adrenoleukodystrophy receiving Lorenzo's oil (glycerol trioleate and glycerol trierucate) who developed purpura, petechiae, and bleeding. Bleeding time was markedly increased (>20 min), although he had only borderline thrombocytopenia (120 x 10(9)/1) and conventional platelet aggregation studies were normal (except for a borderline response to low concentration collagen), as were results using a new technique employing immobilised von Willebrand factor. Together these results suggest that bleeding in this man resulted from a defect in vascular wall function or in the interaction of platelets with the endothelium.
Chai
B C
BC
University of Alberta, Edmonton, Canada.
Etches
W S
WS
Stewart
M W
MW
Siminoski
K
K
D000326:Adrenoleukodystrophy / Q000097:blood / Q000178:diet therapy*; D000328:Adult; D001760:Bleeding Time; D004042:Dietary Fats, Unsaturated / Q000627:therapeutic use*; D004338:Drug Combinations; D004883:Erucic Acids / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D010974:Platelet Aggregation; D010976:Platelet Count; D011693:Purpura / Q000139:chemically induced*; D014304:Triolein / Q000009:adverse effects*
D004042:Dietary Fats, Unsaturated; D004338:Drug Combinations; D004883:Erucic Acids; C079420:Lorenzo's oil; D014304:Triolein