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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Esophageal Varices-I: Introduction01:24

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Barrett Esophagus-I: Introduction01:21

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Gastritis III: Clinical Manifestations and Management01:23

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The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
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Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
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Recurrent Gastrointestinal Bleeding in a Middle-Aged Man.

Faaria Gowani1, Bonnie Phillips2, Christopher Leveque2

  • 1University of Tennessee Health Science Center, Department of Pathology and Laboratory Medicine, Memphis, Tennessee, US.

Laboratory Medicine
|December 23, 2021
PubMed
Summary

This study details a case of acquired von Willebrand disease (avWD) in a patient with gastrointestinal bleeding. Diagnosis involved laboratory tests confirming decreased von Willebrand factor (vWF) and suspected antibody-mediated clearance.

Keywords:
acquired von Willebrand diseasebleeding disordersclottingcoagulationcoagulation testingvon Willebrand factor activity testing

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Area of Science:

  • Hematology
  • Internal Medicine
  • Clinical Pathology

Background:

  • Acquired von Willebrand disease (avWD) is a rare bleeding disorder.
  • It results from factors that reduce functional von Willebrand factor (vWF) levels.
  • Understanding avWD mechanisms is crucial for diagnosis and management.

Observation:

  • A 59-year-old male presented with a 3-year history of recurrent gastrointestinal bleeding.
  • Laboratory findings included a prolonged platelet function assay, decreased vWF antigen, and abnormal vWF multimer analysis.
  • No high-shear stress conditions were identified, prompting suspicion of an antibody-mediated process.

Findings:

  • A vWF mixing study showed complete correction, ruling out a direct functional inhibitor.
  • The patient exhibited a short vWF half-life (2.5 hours) after vWF concentrate administration.
  • A high vWF propeptide/antigen ratio supported antibody-mediated vWF clearance as the cause of avWD.

Implications:

  • This case highlights the critical role of laboratory diagnostics in identifying rare acquired bleeding disorders.
  • Accurate diagnosis of avWD is essential for appropriate treatment strategies.
  • Further research into antibody-mediated mechanisms in avWD is warranted.