High prevalence of acquired von Willebrand's syndrome in patients with thyroid diseases undergoing thyroid surgery.
OBJECTIVE
Various coagulation abnormalities occur in patients with thyroid diseases. These abnormalities range from subclinical laboratory findings to hemorrhage or thromboembolism. However, the prevalence of hemostatic abnormalities in patients with thyroid diseases is still unclear.


METHODS
Between January 1999 and December 2003, 1342 consecutive patients with various thyroid diseases who were candidates for thyroid surgery underwent preoperative screening of hemostatic parameters including prothrombin time, activated partial thromboplastin time and platelet-related hemostasis with the PFA-100 platelet-function analyzer.


RESULTS
Thirty-nine patients (2.9%) had abnormalities of the coagulation screening tests. Of these, 35 patients had von Willebrand's disease (type 1 in 33 cases and type 2A in 2 cases), 2 patients had decreased platelet aggregability, and 2 patients had coagulation factor XI deficiency. As all patients with coagulation abnormalities responded to subcutaneous desmopressin injection (0.3 microg/Kg BW), this drug was successfully used as surgical prophylaxis.


CONCLUSIONS
Up to 3% of patients with thyroid diseases undergoing thyroid surgery have coagulation abnormalities, in most cases resembling von Willebrand's disease. Coagulation screening tests are needed in order to identify those patients at increased risk of bleeding.
Franchini
Massimo
M
Servizio di Immunoematologia e Trasfusione, Centro Emofilia, Azienda Ospedaliera di Verona, Verona, Italy. massimo.franchini@mail.azosp.vr.it <massimo.franchini@mail.azosp.vr.it>
Zugni
Chiara
C
Veneri
Dino
D
Gandini
Giorgio
G
Lippi
Giuseppe
G
Manzato
Franco
F
Brazzarola
Paolo
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001778:Blood Coagulation Disorders / Q000453:epidemiology / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013959:Thyroid Diseases / Q000150:complications* / Q000235:genetics / Q000601:surgery*; D013961:Thyroid Gland / Q000601:surgery*; D014842:von Willebrand Diseases / Q000453:epidemiology*