Allopurinol-induced acquired von Willebrand syndrome

Juan Eirís, Marina Suárez-Terrón, Pablo Granados, David Martínez-Campuzano, Ana Rosa Cid, Saturnino Haya
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Abstract

Acquired von Willebrand syndrome (AVWS) is a relatively infrequent but often overlooked finding when testing for von Willebrand factor (VWF) levels in a patient with mucocutaneous bleeding. Known causes include cardiovascular disorders, hematologic and solid tumors, autoimmune disorders, hypothyroidism, and drugs. An incoercible oral bleeding after a two-teeth removal in a patient with a mechanical aortic valve eventually raised suspicion about an AVWS that was confirmed through laboratory testing. Substitution therapy with an exogenous VWF factor was required to control the bleeding. Known causes of AVWS, including Heyde’s syndrome, were ruled out. VWF levels finally normalized two days after suspension of allopurinol, which the patient received for symptomatic hyperuricemia, leading to his complete recovery and early discharge without any other complications. AVWS is an underdiagnosed entity due to a lack of testing. Allopurinol has never been postured before as a possible etiology and should be evaluated when reaching a diagnosis.
别嘌呤醇诱导获得性血管性血友病综合征
获得性血管性血友病(AVWS)是一种相对少见但经常被忽视的发现,当检测皮肤粘膜出血患者的血管性血友病因子(VWF)水平时。已知的病因包括心血管疾病、血液病和实体瘤、自身免疫性疾病、甲状腺功能减退和药物。一名机械主动脉瓣患者在摘除两颗牙齿后出现不可控制的口腔出血,最终引起了对AVWS的怀疑,并通过实验室检测得到证实。需要外源性VWF因子替代治疗来控制出血。AVWS的已知病因,包括Heyde综合征,都被排除在外。患者因症状性高尿酸血症而停用别嘌呤醇两天后,VWF水平终于恢复正常,患者完全康复并提前出院,无其他并发症。由于缺乏检测,AVWS是一个未被诊断的实体。别嘌呤醇以前从未被认为是一种可能的病因,在诊断时应进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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