PMID- 31656571
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2041-4137 (Print)
IS  - 2041-4145 (Electronic)
IS  - 2041-4137 (Linking)
VI  - 10
IP  - 4
DP  - 2019 Oct
TI  - Rituximab to the rescue: novel therapy for chronic gastrointestinal bleeding due 
      to angiodysplasia and acquired von Willebrand syndrome.
PG  - 434-437
LID - 10.1136/flgastro-2018-101116 [doi]
AB  - 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.
CI  - (c) Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Hawken, James
AU  - Hawken J
AD  - Department of Gastroenterology, Weston General Hospital, Weston-super-Mare, UK.
AD  - Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, 
      Bristol, UK.
FAU - Knott, Amy
AU  - Knott A
AD  - Bristol Haematology Unit, University Hospitals Bristol NHS Foundation Trust, 
      Bristol, UK.
FAU - Alsakkaf, Wesam
AU  - Alsakkaf W
AD  - Department of Haematology, Weston General Hospital, Weston-super-Mare, UK.
FAU - Clark, Amanda
AU  - Clark A
AD  - Bristol Haematology Unit, University Hospitals Bristol NHS Foundation Trust, 
      Bristol, UK.
FAU - Fayyaz, Faisal
AU  - Fayyaz F
AD  - Department of Gastroenterology, Weston General Hospital, Weston-super-Mare, UK.
LA  - eng
PT  - Case Reports
DEP - 20190109
PL  - England
TA  - Frontline Gastroenterol
JT  - Frontline gastroenterology
JID - 101528589
PMC - PMC6788123
OTO - NOTNLM
OT  - angiodysplasia
OT  - gastrointestinal bleeding
COIS- Competing interests: None declared.
EDAT- 2019/10/28 06:00
MHDA- 2019/10/28 06:01
PMCR- 2020/10/01
CRDT- 2019/10/29 06:00
PHST- 2018/10/02 00:00 [received]
PHST- 2018/11/19 00:00 [revised]
PHST- 2018/12/14 00:00 [accepted]
PHST- 2019/10/29 06:00 [entrez]
PHST- 2019/10/28 06:00 [pubmed]
PHST- 2019/10/28 06:01 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - flgastro-2018-101116 [pii]
AID - 10.1136/flgastro-2018-101116 [doi]
PST - ppublish
SO  - Frontline Gastroenterol. 2019 Oct;10(4):434-437. doi: 
      10.1136/flgastro-2018-101116. Epub 2019 Jan 9.