Severe Thrombocytopenia in the Post-surgical Context and Administration of Factor VIIII (FVIII)/von Willebrand Factor (VWF) Concentrate in a Patient With von Willebrand Disease Type 2M

TL;DR

This paper discusses a challenging case of severe low platelet count in a patient with von Willebrand disease after surgery, linked to treatment with a blood clotting factor.

Contribution

The paper highlights a rare complication of thrombocytopenia possibly caused by FVIII/VWF concentrate administration in a post-surgical VWD patient.

Findings

The patient's platelet count worsened following administrations of Wilate.

The case suggests a potential direct relationship between Wilate and thrombocytopenia.

Balancing hemorrhage prevention and thrombosis risk is critical in VWD management.

Abstract

Von Willebrand disease (VWD) is the most common inherited bleeding disorder. It can be associated with a life-threatening risk of excessive bleeding in surgical procedures, and may require prophylactic treatment with a combined factor VIIII (FVIII)/von Willebrand factor (VWF) concentrate. Management of these patients may be challenging when trying to achieve the balance between avoiding the risk of haemorrhage and causing a risk of thrombosis with the treatment. We present a complex case of severe thrombocytopenia in a post-surgical setting, in which the timeline suggests a direct relationship between the worsening of platelet count and wilate administrations.

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