Successful endoscopic clipping for bleeding from colonic angiodysplasia in a case of Heyde syndrome.
BACKGROUND
Aortic valve sclerosis, calcification, and stenosis are common in the elderly. Increased life expectancy has resulted in a growing population of elderly people, with a corresponding increase in the number of patients with these degenerative aortic valve diseases.


METHODS
We report a case of severe aortic stenosis in an 82-year-old woman with bleeding due to colonic angiodysplasia. The patient presented with anemia unexpectedly before her aortic valve replacement. Colon fiberscopy revealed that colonic angiodysplasia was responsible for the bleeding. The lesion was treated with endoscopic clipping before the successful aortic valve replacement. Additionally, her immunoblot analysis detected a decrease of large molecular weight multimers of von Willebrand factor.


CONCLUSIONS
The relationship between aortic valve stenosis, acquired von Willebrand disease and gastrointestinal bleeding in elderly patients is known as Heyde syndrome. Clinicians should be aware of the possibilities of acquired von Willebrand disease and gastrointestinal bleeding from angiodysplasia in patients with aortic valve stenosis.
Takahashi
Nobuyuki
N
4th Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo City, Shimane, Japan. yukihiro@med.shimane-u.ac.jp
Tanabe
Kazuaki
K
Yoshitomi
Hiroyuki
H
Sato
Masatake
M
Kitamura
Jun
J
Sato
Hidetoshi
H
Ishibashi
Yutaka
Y
Shimada
Toshio
T
Oda
Teiji
T
D000015:Abnormalities, Multiple / Q000601:surgery*; D000369:Aged, 80 and over; D016888:Angiodysplasia / Q000150:complications* / Q000601:surgery*; D003108:Colonic Diseases / Q000150:complications* / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006470:Hemorrhage / Q000150:complications* / Q000601:surgery; D006801:Humans; D055503:Protein Multimerization; D013577:Syndrome; D014841:von Willebrand Factor / Q000378:metabolism
D014841:von Willebrand Factor