Successful treatment with recombinant factor VIIa of therapy-resistant severe bleeding in a patient with acquired von Willebrand disease

Authors

  • Philip W. Friederich,

    Corresponding author
    1. Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    2. Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • Department of Vascular Medicine, Academic Medical Center, Room F4-136, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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  • Peter C. Wever,

    1. Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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  • Ernest Briët,

    1. Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands
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  • Cornelis J. Doorenbos,

    1. Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands
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  • Marcel Levi

    1. Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    2. Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Abstract

We describe an elderly man who presented with life-threatening hematuria and gastrointestinal bleeding caused by acquired von Willebrand disease associated with monoclonal gammopathy of undetermined significance (MGUS). Standard therapy with desmopressin, von Willebrand factor-containing factor VIII concentrate, tranexamic acid, and immunoglobulin failed to achieve adequate hemostasis. However, treatment with recombinant activated factor VII (rFVIIa) arrested the bleeding completely. Since acquired von Willebrand disease can lead to life-threatening hemorrhage, clinicians should consider rFVIIa as an effective treatment option if standard therapy fails. Am. J. Hematol. 66:292–294, 2001. © 2001 Wiley-Liss, Inc.

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