# Left Renal Artery Thrombosis in a Patient With von Willebrand Disease Type 3 and Factor V Leiden Heterozygosity

## TL;DR

A rare case of a man with severe bleeding disorder and a blood clotting condition developed a rare arterial clot in his kidney.

## Contribution

First reported case of VWD type 3 combined with FVL causing arterial thrombosis.

## Key findings

- A patient with VWD type 3 and FVL heterozygosity developed left renal artery thrombosis.
- This case highlights the possibility of arterial thrombosis in severe bleeding disorders.
- Treatment considerations for such combined disorders are not well documented.

## Abstract

There are a few cases of combined thrombotic and hemophilic disorders coexisting in patients that have been published in the literature, such as factor V Leiden (FVL) with von Willebrand disease (VWD) type 1, and a report of a patient with VWD type 3, protein C and antithrombin III deficiency, and venous thromboses, but no reports in the literature were found of a patient with VWD type 3 and FVL and arterial thromboses. VWD type 3 is the most severe form because it results in nonexistent levels of von Willebrand factor (VWF) and is believed to be protective against arterial thromboses. We present a unique case of a 41-year-old man with a known history of VWD type 3 who presented with left renal artery thrombosis and a large left renal infarct, who was subsequently diagnosed with FVL heterozygosity. Both FVL and VWD type 3 can coexist in a patient. These patients require special considerations in treatment that have not been well documented throughout the literature.