Recurrent severe bleeding from gastrointestinal angiodysplasia in a patient with von Willebrand's disease, controlled with recombinant factor VIIa.
A patient with von Willebrand's disease had recurrent gastrointestinal bleeding from angiodysplasia, with inadequate response to von Willebrand factor substitution, medical and endoscopic treatment, and resection of affected bowel. Frequent blood transfusions were required. She started home treatment with recombinant activated factor VII (rFVIIa) at the onset of bleeding, in addition to her standard therapy. From then on, bleeds could be controlled rapidly and no more blood transfusions were needed. We conclude that rFVIIa is effective in this case of angiodysplasia and might be a therapeutic option in similar patients.
Meijer
K
K
Division of Haemostasis, Thrombosis and Rheology, University Hospital Groningen, The Netherlands. karinameijer@hetnet.nl
Peters
F T
FT
van der Meer
J
J
D016888:Angiodysplasia / Q000150:complications*; D001803:Blood Transfusion; D003131:Combined Modality Therapy; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D004967:Estrogens / Q000627:therapeutic use; D005169:Factor VIII / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D005773:Gastroscopy; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D007579:Jejunal Diseases / Q000150:complications* / Q000601:surgery; D008551:Melena / Q000209:etiology; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D014148:Tranexamic Acid / Q000627:therapeutic use; D016896:Treatment Outcome; D014842:von Willebrand Diseases / Q000150:complications* / Q000188:drug therapy; D014841:von Willebrand Factor / Q000627:therapeutic use
D004967:Estrogens; D011994:Recombinant Proteins; D014841:von Willebrand Factor; D014148:Tranexamic Acid; D005169:Factor VIII; D007501:Iron; D015942:Factor VIIa; D003894:Deamino Arginine Vasopressin; D009853:Omeprazole