American Journal of Case Reports最新文献

{"title":"Local Injection of Fluid Gelatin Under Contrast-Enhanced Ultrasound Guidance for Treating Active Bleeding From the Inferior Epigastric Artery: A Case Report.","authors":"Xiaohui Li, Ningbo Zhao, Lin Zhong, Yu Zhang, Yongfang Luo","doi":"10.12659/AJCR.947297","DOIUrl":"10.12659/AJCR.947297","url":null,"abstract":"<p><p>BACKGROUND Injury to the inferior epigastric artery is a major complication of abdominal puncture, and continuous active bleeding from this artery can lead to hemorrhagic shock. Several studies have reported the use of contrast-enhanced ultrasound (CEUS) to diagnose active bleeding in parenchymal organs. Fluid gelatin is a new hemostatic material that can be injected into the bleeding site by using a puncture needle under the precise guidance of CEUS, which enables the implementation of local minimally invasive and appropriate hemostatic treatment. Here, we report the case of a patient in whom CEUS was used to accurately locate the bleeding site before surgery and guide local injection of fluid gelatin with a puncture needle to successfully achieve nonsurgical treatment of hemostasis. CASE REPORT A 62-year-old man with post-hepatitis B cirrhosis underwent a successful liver transplant surgery. After surgery, abdominal puncture and drainage were performed because of a large amount of peritoneal effusion due to nephrotic syndrome. The drainage fluid was bright red bloody liquid. CEUS revealed many contrast agent microbubbles extravasating from the inferior epigastric artery into peritoneal effusion along the abdominal puncture tract. Surgical suturing and applying a compression bandage failed to achieve satisfactory results. After receiving the patient's consent, thrombin and hemostatic glue were injected locally under the guidance of CEUS. Finally, hemostasis was successfully achieved. CONCLUSIONS CEUS-guided injection of fluid gelatin is a safe and effective treatment method and could serve as an effective measure for nonsurgical treatment and postoperative supplementary treatment of active bleeding from the inferior epigastric artery.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947297"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Transplant Success in Severe Diquat Poisoning: A Case Report.","authors":"Fanjie Meng, Yan Zhang, Hongfei Cai, Fanyu Meng, Bohao Liu, Yang Li","doi":"10.12659/AJCR.947421","DOIUrl":"10.12659/AJCR.947421","url":null,"abstract":"<p><p>BACKGROUND Diquat is a commonly used herbicide in China, which has the potential to induce severe or fatal poisoning in humans. Diquat is extremely lethal to humans and there is no antidote available. CASE REPORT We report the case of a 26-year-old woman who experienced nausea, vomiting, coughing, and general fatigue after ingesting 80 mL of 20% diquat. Due to the toxic effects of diquat, the patient's condition progressed rapidly, resulting in sequential impairments of liver and kidney function, as well as the development of pulmonary fibrosis. Prior to the surgical procedure, she was supported by extracorporeal membrane oxygenation (ECMO) to manage the preoperative dyspnea. On the 28th day, she a double-lung transplant. On the 8th postoperative day, she was diagnosed with a pulmonary embolism and subsequently accepted right upper-lobe resection surgery. On the 175th postoperative day, she patient was diagnosed with airway stenosis and then underwent tracheal covered stent implantation. Following the lung transplantation, she participated in an active rehabilitation program, complied with the prescribed anti-rejection medication regimen, attended regular follow-up appointments, and had a favorable prognosis. CONCLUSIONS Lung transplantation is currently the most effective treatment for pulmonary fibrosis, and ECMO serves as a temporary support mechanism for patients who have experienced severe diquat poisoning and are awaiting lung transplantation. The complex perioperative complications of the diquat itself can be successfully managed by a multidisciplinary team. The clinicians should be aware of the risk of pulmonary embolism after lung transplantation.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947421"},"PeriodicalIF":1.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Innovative Endovascular Approach to Pancreatic Transplant Artery Y-Graft Aneurysm Complications Using Elective Endovascular Techniques: A Case Report.","authors":"Pooja Krishnaswamy, Ming Yii","doi":"10.12659/AJCR.946786","DOIUrl":"10.12659/AJCR.946786","url":null,"abstract":"<p><p>BACKGROUND Pancreatic transplant is the only definitive treatment to restore normoglycemia for autoimmune type 1 diabetes, but it is associated with significant morbidity due to its complexity from the index operation and sequelae. Vascular complications, including thrombosis and pseudoaneurysms, can have significant impacts on pancreatic transplant graft function. CASE REPORT Pancreatic transplant artery aneurysm is a rare complication of pancreas transplant. Vascular complications of transplants, including aneurysm rupture, are life-threatening and can require transplant pancreatectomy. We present a rare case of a chronic pancreatic transplant Y-graft arterial pseudoaneurysm of unknown etiology, 20 years after the initial simultaneous pancreas and kidney transplant. Due to the chronicity, previous significant adhesiolysis from a cholecystectomy, unlikelihood of a mycotic aneurysm, and concern for thrombus propagation leading to graft dysfunction, an endovascular approach was used. A combination of covered endovascular stents was deployed to maintain adequate blood flow to the pancreas allograft. Following endovascular Y-stenting, the patient maintained pancreatic graft function with no signs of allograft rejection. CONCLUSIONS Endovascular stenting can be used to treat chronic transplant pancreatic artery aneurysms and offers a less invasive treatment alternative to open surgery.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946786"},"PeriodicalIF":1.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory Nerve Palsy as the Initial Manifestation of Chronic Lymphocytic Leukemia: A Case Report.","authors":"Zaid Al-Deerawi, Ali Shaladi, Anton G Borg, Matt Stanislas, Husham Barrak","doi":"10.12659/AJCR.948534","DOIUrl":"10.12659/AJCR.948534","url":null,"abstract":"<p><p>BACKGROUND Chronic lymphocytic leukemia is the most common leukemia affecting adults, classically presenting with painless lymphadenopathy or diagnosed incidentally on routine full blood count. Neurological complications rarely arise in chronic lymphocytic leukemia and the underlying causes for such complications remain poorly understood. Cranial nerve involvement is uncommon and there are currently no reported cases of accessory nerve palsy as the first presentation of chronic lymphocytic leukemia. CASE REPORT A woman in her 40s presented with a 4-week history of left-sided neck swelling and pain associated with left shoulder restriction. Left trapezius weakness and scapular winging was found on examination, consistent with a left accessory nerve palsy. Examination also revealed multiple tender lymph nodes in the left posterior triangle of the neck. Investigations included a staging CT scan, flexible nasendoscopy, nerve conduction studies, and a full blood count showing lymphocytosis. A work-up involving Ear, Nose, and Throat Surgery, Hematology, and Orthopedic Surgery led to the diagnosis of chronic lymphocytic leukemia. There was no evidence of Richter's transformation. A multidisciplinary team approach was used to treat the patient, and there was complete resolution of her neurological symptoms on follow-up. CONCLUSIONS This report describes an unusual first presentation of chronic lymphocytic leukemia. It serves as a reminder to consider hematological malignancies in cases of accessory nerve palsy associated with a neck swelling. Early input from Hematology and multidisciplinary involvement can aid early diagnosis and prevent unnecessary investigations. Further research is warranted to explore the neurological spectrum of CLL.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948534"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granulomatosis with Polyangiitis Presenting as Pancreatic Pseudotumor and Peripancreatic Lymphadenitis: Diagnostic Challenges and Review of 55 Cases.","authors":"Camille Beniada, Yann Coattrenec, Sahar Mack, Alexis Ricoeur, Volkan Adsay, Giacomo Puppa, Jörg D Seebach","doi":"10.12659/AJCR.945741","DOIUrl":"10.12659/AJCR.945741","url":null,"abstract":"<p><p>BACKGROUND The spectrum of anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) encompasses granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA). These pathologies predominantly affect small to medium-sized vessels, with frequent involvement of the ear, nose, and throat (ENT) sphere, lungs, and kidneys. Pancreatic involvement, an exceedingly rare manifestation of AAV, manifests as pancreatitis, a pancreatic mass, or a cystic lesion. This study reports a new case of pancreatic GPA and reviews the literature to characterize its clinical, radiological, and histological features. CASE REPORT A 54-year-old woman with severe epigastric pain, vomiting, and weight loss presented with a pancreatic mass and peripancreatic lymphadenitis on imaging studies, raising high suspicion for cancer. Repeated endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsies were inconclusive. Distal pancreatectomy with splenectomy was performed. Histopathology demonstrated granulomatous inflammation with necrosis and vasculitis, and anti-PR3 ANCA testing was positive. A diagnosis of GPA was made and treatment with corticosteroids and rituximab resulted in clinical remission. We identified 54 additional cases of pancreatic AAV in the literature and analyzed their clinical features. CONCLUSIONS In cases of unexplained pancreatitis or pancreatic masses/pseudocysts, AAV should be considered. A targeted evaluation - including ANCA testing, imaging, biopsies, and a systematic search for ENT, lung, kidney, and skin manifestations - is essential to identify key clinical, serological, and radiological clues of pancreatic AAV. We propose to classify this as type 4 autoimmune pancreatitis. A corticosteroid-based regimen, with or without additional immunosuppressants, offers effective disease control, making pancreatic surgery unnecessary.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e945741"},"PeriodicalIF":1.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histoplasma-Induced Esophageal Ulcers in HIV/AIDS Patient: A Case Report.","authors":"Taylor Brooke Kenneda, Teagan L Willard, Ryan Demkowicz, Megan Willard","doi":"10.12659/AJCR.948028","DOIUrl":"10.12659/AJCR.948028","url":null,"abstract":"<p><p>BACKGROUND Patients with HIV/AIDS can develop opportunistic infections of the esophagus. While Candida frequently causes infectious esophagitis in this population, other opportunistic infections, like cytomegalovirus and herpes simplex virus, can cause esophagitis, and in some cases, esophageal ulcers. Less frequent opportunistic infections of the esophagus include histoplasmosis. CASE REPORT A 58-year-old man with a history of HIV presented to the hospital with esophageal dysphagia. He had a history of disseminated histoplasmosis and was on itraconazole. Upper endoscopy done for the dysphagia revealed large, deeply cratered esophageal ulcers, a common cause of esophageal dysphagia. Ulcer biopsies were obtained, with routine staining negative for HIV, cytomegalovirus, yeast, or fungal organisms. He was started on acid suppressive therapy, with no improvement in dysphagia. Laboratory test results were significant for subtherapeutic levels of itraconazole therapy and positive urine Histoplasma antigen. These new findings raised concern for histoplasmosis being the cause of the patient's esophageal ulcers. Therefore, the team conducted specialized Grocot-Gomori methenamine silver staining on tissue from the esophageal ulcers, which revealed Histoplasma. For disseminated histoplasmosis treatment, he was admitted for intravenous amphotericin, and his outpatient dose of itraconazole was adjusted. Dysphagia subsequently improved, and follow-up upper endoscopy revealed esophageal ulcers had resolved. CONCLUSIONS This case underscores Histoplasma capsulatum as a rare but significant cause of esophageal ulceration in patients with HIV/AIDS. Proper diagnostic approaches, including specialized staining techniques, are critical when routine examinations fail to identify a pathogen. In patients with HIV/AIDS, clinicians should be keen to consider alternate, less common, causes of esophageal ulcers.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948028"},"PeriodicalIF":1.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Venous Thrombosis Following a Lumbar Puncture in a Patient Using NuvaRing.","authors":"Rida Altaf, Mousa Thalji, Jose Serriera, Madison French, Mario Madruga, Stephen J Carlan","doi":"10.12659/AJCR.947368","DOIUrl":"10.12659/AJCR.947368","url":null,"abstract":"<p><p>BACKGROUND Lumbar puncture (LP) is a key diagnostic tool for various pathologies but can lead to complications, including post-LP headache (PLPH). Post-LP cerebral venous thrombosis (CVT) is a rare but serious complication with an annual incidence of 1.16 to 2.02 per 100 000 population. It is more common in females, with a ratio of 3: 1 compared to males. Exogenous estrogen use is an antecedent risk factor for thrombosis. CASE REPORT A 29-year-old woman, gravida 0 with a 3-year history of using etonogestrel/ethinyl estradiol vaginal ring (NuvaRing) for contraception, presented to the emergency room with 2 days of fever, altered mental status, and body aches. Her initial imaging showed no abnormalities, including head computed tomography (CT), CT angiography, and head magnetic resonance imaging (MRI). An LP was negative. A persistent headache prompted placement of an epidural blood patch 6 days later, and a subsequent MRI revealed a thrombus in the superior sagittal sinus and a cortical infarct. Use of the NuvaRing was discontinued, and the patient was treated with anticoagulants. Follow-up imaging showed chronic venothrombotic changes but no new thrombosis. The diagnosis of the condition leading to the original admission and workup was never determined. CONCLUSIONS Post-LP cerebral venous thrombosis can be life-threatening if not promptly diagnosed and treated. Persistent headaches, new neurological deficits, and unexplained symptoms after LP should prompt investigation for cerebral venous thrombosis. Early diagnosis with MRI with magnetic resonance venography (MRV) and appropriate anticoagulation therapy are crucial for managing this complication. The combination of a NuvaRing and LP temporally associated with a CVT is unreported and likely increased her risk of thrombosis.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947368"},"PeriodicalIF":1.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Pharyngeal Perforation with Cervical Spine Injury Following Blunt Trauma on Electric Vehicle Accident.","authors":"Yinkui Wang, Dengfeng Wang, Tinglao Chen, Xiaoli Zhu","doi":"10.12659/AJCR.947274","DOIUrl":"10.12659/AJCR.947274","url":null,"abstract":"<p><p>BACKGROUND Cases of pharyngeal perforation (PP) associated with cervical spine injury following blunt trauma are extremely rare. CASE REPORT A 58-year-old woman was hit by a car while riding an electric bicycle. She presented with neck pain and dyspnea on admission to the hospital. The CT scan showed suspected fractures of the 5th and 6th cervical vertebrae without evidence of cervical emphysema. Serial blood tests revealed a rapidly decreasing hemoglobin level. An urgent surgical exploration of the neck was performed. Intraoperative findings included complete tears of the anterior and posterior longitudinal ligaments of the cervical spine, rupture of the 5th and 6th cervical intervertebral discs, and a longitudinal laceration of the posterior pharyngeal wall. The patient underwent surgical management, which included PP repair and cervical spine infusion via an anterior cervical approach. The buccopharyngeal fascia was sutured to the prevertebral fascia to seal the connection between the PP and the prevertebral space. The patient recovered well after surgery. The 3-month postoperative follow-up showed a stable cervical spine and good healing of the PP. CONCLUSIONS We present the first case of PP associated with severe cervical spine injury following blunt trauma. Direct laryngoscopy is essential to establish the presence of PP and to assess the size and location of the injury. In this rare case, suturing the buccopharyngeal fascia and prevertebral fascia to isolate the PP and spinal implant was effective in preventing implant infection and surgical failure potentially caused by salivary leakage.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947274"},"PeriodicalIF":1.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Abdominal Pain Onset in Guillain-Barré Syndrome: A Case Report of Acute Motor Sensory Axonal Neuropathy.","authors":"Muhammad Aidil Idham Sharom, Julina Md Noor, Mohd Fazrul Mokhtar","doi":"10.12659/AJCR.946737","DOIUrl":"10.12659/AJCR.946737","url":null,"abstract":"<p><p>BACKGROUND Guillain-Barre syndrome (GBS) typically presents with ascending weakness and sensory disturbances. However, initial symptoms like abdominal pain are rare and can make diagnosis more challenging, as this is not a common feature of GBS. This diagnostic delay can be particularly significant in severe GBS subtypes like acute motor and sensory axonal neuropathy (AMSAN), with only a few reported cases presenting in this atypical manner. CASE REPORT A 42-year-old man experienced 3 days of persistent abdominal pain that progressively disrupted his normal activities. Soon after, he developed weakness and loss of sensation, beginning in his lower limbs and eventually spreading to the upper limbs. His condition rapidly deteriorated, resulting in respiratory failure that required intubation. Upon examination, muscle weakness and sensory loss were noted, leading to a diagnosis of AMSAN. This was confirmed by nerve conduction studies, MRI, and cerebrospinal fluid analysis. The patient initially received intravenous immunoglobulin (IVIG) but showed minimal improvement after 8 days. He then underwent plasma exchange, consisting of 5 treatment cycles. After 64 days in the hospital, including 39 days in the intensive care unit (ICU), he was discharged and able to walk with assistance. CONCLUSIONS This case highlights the importance of recognizing the atypical presentations of GBS, particularly the AMSAN subtype. The patient's initial presentation of severe abdominal pain, followed by rapid neurological deterioration, underscores the need for clinicians to maintain a high index of suspicion for GBS even when symptoms diverge from the classic ascending paralysis.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946737"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Pure VWF and VWF/FVIII Complex in Orthopedic Surgery for Type 2B von Willebrand Disease.","authors":"Pierre Chamouni, Virginie Barbay, Paul Billoir, Veronique Le Cam Duchez","doi":"10.12659/AJCR.947187","DOIUrl":"10.12659/AJCR.947187","url":null,"abstract":"<p><p>BACKGROUND This report describes a 55-year-old man with hypertension, hypercholesterolemia, type 2B von Willebrand disease (VWD2B), and thrombocytopenia requiring 2 surgical total hip replacements managed with pure von Willebrand factor (VWF) concentrate (Wilfactin®) and VWF/Factor VIII (FVIII) complex concentrate (Voncento®). VWD2B is a rare, autosomal-dominant, inherited disorder of primary hemostasis caused by VWF alterations that increase its affinity for the GP1b receptor on circulating platelets. In some families, thrombocytopenia of varying severity is observed. This can worsen the hemorrhagic phenotype and require adapted management. Specific laboratory tests and genetic studies are used to confirm the diagnosis of VWD2B, particularly before surgery in which VWF concentrates may be required. CASE REPORT This patient underwent 2 hip replacement interventions, 3.5 months apart, performed by the same surgical team. Hemorrhage prevention was achieved using Wilfactin® for the first hip replacement procedure and required 9 injections of Wilfactin® (352.9 IU/kg). For the second hip replacement, which took place 3.5 months after, we used Voncento® to prevent bleeding and required 8 injections of Voncento® (282.3 IU/kg). Both treatments were effective in terms of bleeding prevention. No thrombotic event was reported. The hospital stay duration was identical for both interventions. CONCLUSIONS Here, we report a real-life comparison of Wilfactin® and Voncento® in the same patient and in the same peri-operative management conditions. This study confirms the efficacy and safety of these VWF concentrates in preventing bleeding without thrombotic risks and highlights the benefits of close laboratory monitoring to personalize treatment and optimize management.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947187"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}