Rare Cause of Acquired Increased Bleeding Propensity

DOI: 10.3238/zfa.2017.0522–0525

german translation / full article

Annette Luther, Lothar Schott, Oliver Pech, Christina Hart

Keywords: Acquired von Willebrand disease bleeding disorders Heyde`s syndrome gastrointestinal angiodysplasia aortic stenosis

Background: Acquired bleeding disorders may have different causes. The first important diagnostic approach is a precise review of the patient´s history including bleeding diathesis, medication and comorbidities as well as a physical examination.

Case report: An 82-year old female patient with recurrent epistaxis was treated several times by an ear, nose and throat specialist. Due to intestinal bleeding signs, the patient was admitted to a gastroenterologic department. Endoscopy did not show any source of bleeding. During hospitalization severe anemia occurred and blood transfusions were needed. The reason for the bleeding was diagnosed rather late.

Conclusions: After common causes of acquired bleeding disorders have been ruled out also rare causes should be considered. Heyde‘s syndrome describes bleeding from angiodysplasia in patients with severe aortic stenosis and is based on mechanical disruption of von Willebrand multimers during turbulent passage through the narrowed valve.

(State: 15.12.2017)

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