title: High prevalence of acquired von Willebrand's syndrome in patients with thyroid diseases undergoing thyroid surgery.
abstract: 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.
authors.affiliation: 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>
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchini
authors.forename: Chiara
authors.initials: C
authors.lastname: Zugni
authors.forename: Dino
authors.initials: D
authors.lastname: Veneri
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gandini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.forename: Franco
authors.initials: F
authors.lastname: Manzato
authors.forename: Paolo
authors.initials: P
authors.lastname: Brazzarola
mesh_terms: 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*