Early transfusion of factor VIII/von Willebrand factor concentrates seems to be effective in the treatment of gastrointestinal bleeding in patients with von Willebrand type III disease.
The association between gastrointestinal angiodysplasia and von Willebrand disease was reported 30 years ago. The clinical course of patients with von Willebrand disease and angiodysplasia is characterized by numerous admissions to hospital for gastrointestinal bleeding necessitating transfusion with packed red cells, factor VIII and plasma. The management of these patients is problematic. Numerous treatments for the gastrointestinal bleeding have been proposed: surgery, electrocoagulation, laser photocoagulation, sclerotherapy, arteriography with embolization, immunoglobulins, oestrogens, and octreotide, but no treatment modality has been successful in all cases. We report a 66-year-old-female with small bowel angiodysplasia and von Willebrand type III disease in whom prompt administration of factor VIII/vWF concentrates was effective. Education of patients to recognize minimal gastrointestinal bleeding manifestations, periodical clinical visits and early infusion of factor VIII/vWF seems to be fundamental for the success of this therapy. A longer follow-up and the study of other patients are needed to confirm our observation.
Zanon
E
E
Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy. zanezio@tiscalinet.it
Vianello
F
F
Casonato
A
A
Girolami
A
A
D000368:Aged; D016888:Angiodysplasia / Q000209:etiology; D016913:Blood Component Transfusion; D005169:Factor VIII / Q000008:administration & dosage*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D010353:Patient Education as Topic; D016353:Self-Examination; D014842:von Willebrand Diseases / Q000150:complications* / Q000188:drug therapy; D014841:von Willebrand Factor / Q000008:administration & dosage*
D014841:von Willebrand Factor; D005169:Factor VIII