Rituximab to the rescue: Novel therapy for chronic gastrointestinal bleeding due to angiodysplasia and acquired von Willebrand syndrome

James Hawken*, Amy Knott, Wesam Alsakkaf, Amanda Clark, Faisal Fayyaz

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)

Abstract

Identification of acquired von Willebrand syndrome (AVWS) was key to treating a patient with chronic gastrointestinal (GI) bleeding due to angiodysplasia. After exhausting endoscopic and pharmacological options, the patient was successfully treated with rituximab. A 78-year-old man developed chronic GI bleeding from caecal and jejunal angiodysplasia. Red cell transfusion was required weekly despite argon plasma coagulation. A diagnosis of AVWS was made from analysis of clotting factors. Therapies including von Willebrand factor concentrate, thalidomide and tranexamic acid were unsuccessful. With failed endoscopic therapy and no viable surgical option, the patient was given intravenous immunoglobulins (IVIGs). Haemoglobin remained stable from this point. The impact on the patient and hospital of attending for IVIG every 3 weeks necessitated consideration to longer-term therapy. After a single course of rituximab, no further blood products, IVIG or rituximab were required. This case is the first to describe the use of rituximab in AVWS-associated angiodysplasia.

Original languageEnglish
Pages (from-to)434-437
Number of pages4
JournalFrontline Gastroenterology
Volume10
Early online date9 Jan 2019
DOIs
Publication statusPublished - 6 Sep 2019

Keywords

  • angiodysplasia
  • gastrointestinal bleeding

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