title: Highly substituted hydroxyethyl starch (HES200/0.62) leads to Type-I von Willebrand syndrome after repeated administration.
abstract: Hydroxyethyl starch (HES) is a frequently used plasma substitute that is popular due to a high degree of therapeutic safety. However, the administration of large volumes of highly substituted, high-molecular-weight starch often leads to iatrogenic von Willebrand syndrome (vWS) with hemorrhagic complications. In patients with cerebral circulatory disturbances we carried out hemodilution therapy during 9-10 days, infusing HES 200/0.62. A von Willebrand factor (vWF) multimeric analysis was carried out in 6 patients using a modified western blot according to the sodium dodecyl sulfate agarose gel electrophoresis method. The vWF multimeric analysis showed that all multimers decreased to the same degree, corresponding to type-I vWS.
authors.affiliation: Department of Neurology, University of the Saarland, Homburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Treib
authors.forename: A
authors.initials: A
authors.lastname: Haass
authors.forename: G
authors.initials: G
authors.lastname: Pindur
authors.forename: C
authors.initials: C
authors.lastname: Miyachita
authors.forename: M T
authors.initials: MT
authors.lastname: Grauer
authors.forename: F
authors.initials: F
authors.lastname: Jung
authors.forename: E
authors.initials: E
authors.lastname: Wenzel
authors.forename: K
authors.initials: K
authors.lastname: Schimrigk
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D005260:Female; D005884:Gingival Hemorrhage / Q000139:chemically induced; D006438:Hemodilution; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D010314:Partial Thromboplastin Time; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014842:von Willebrand Diseases / Q000139:chemically induced*; D014841:von Willebrand Factor / Q000037:antagonists & inhibitors* / Q000737:chemistry
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D014841:von Willebrand Factor