Hypothyroidism as a Cause of Acquired Von Wdllebrand's Disease

Dalton, R.G.; Savidge, Geoffrey F.; Matthews, K.B.; Dewar, M.S.; Kernoff, P. B. A.; Greaves, M.; Preston, F. E.

doi:10.1016/s0140-6736(87)92272-0

Cited by 134 publications

(98 citation statements)

References 17 publications

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“…In turn, subjects with polycythemia vera may benefit from bloodletting [35]. Resolution of AvWS was also observed after the surgical removal of a malignancy, cardiac surgeries (valve replacement) and thyroxin substitution during the course of hypothyroidism [10,46,47]. Also withdrawing agents that might contribute to the development of AvWS (ciprofloxacin, griseofulvin, tetracycline, valproic acid, HES) may result in the remission of this condition [45].…”

Section: Treatmentmentioning

confidence: 99%

Acquired von Willebrand Syndrome

Mital¹

2016

Adv Clin Exp Med

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Section: Treatmentmentioning

confidence: 99%

Acquired von Willebrand Syndrome

Mital¹

2016

Adv Clin Exp Med

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“…These modifications involve both primary and secondary hemostasis, and may range from minor subclinical alterations to significant clinical disturbances. Acquired von Willebrand disease is the most relevant coagulation abnormality in hypothyroidism (8)(9)(10)(11). Published data, although limited, suggest that the coagulation and fibrinolytic systems are disturbed in different ways, depending on the severity of hypothyroidism (12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the respective influence of thyroid hormones and TSH on blood coagulation parameters after total thyroidectomy

Yango¹,

Alexopoulou²,

Eeckhoudt

et al. 2011

European Journal of Endocrinology

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Background: Several hemostatic abnormalities have been described in hypothyroidism, such as modification of coagulation proteins and bleeding tendency. Although thyroid hormone deficiency is considered to be responsible for these changes, the underlying mechanisms have not yet been established. Objective: To evaluate the respective influence of peripheral thyroid hormones (free thyroxine) and TSH on blood clotting by assessing coagulation parameters in patients with a history of total thyroidectomy for thyroid cancer, under three different conditions: induced hypothyroidism, euthyroid state, and following recombinant human TSH (rhTSH) administration. Methods: Coagulation parameters (platelet count, fibrinogen, international normalized ratio, prothrombin time, thrombin time, activated partial thromboplastin time (APTT), factor VIII activity ((FVIII:C), as well as von Willebrand factor antigen (VWF:Ag) and VWF activity using collagen binding assay (VWF:CBA)) were measured in patients with severe hypothyroidism following withdrawal of thyroid hormone replacement therapy, and in the same patients with euthyroidism after restoring replacement treatment (group A), and before and after administering rhTSH (group B). Results: FVIII:C, VWF:Ag, and VWF:CBA were significantly decreased (P!0.001), whereas APTT was significantly increased (P!0.001) in patients with severe hypothyroidism compared with patients in the euthyroid state. No changes in clotting parameters were observed in patients who received rhTSH therapy.Conclusion: This prospective study shows that severe short-term hypothyroidism is associated with significantly lower levels of VWF:Ag, VWF:CBA, and FVIII:C. Administration of exogenous TSH has no effect on coagulation parameters. These findings suggest that thyroid hormone deficiency is likely to be the main cause of coagulation alterations in patients with hypothyroidism.

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“…CONCLUSION Our results suggest that In hypothyrold patlents desmopressln may be of value for the acute treatment of bleedlng or as cover for surgery. extraction (Dalton et al, 1987;Smith & Auger, 1987). Surgery or biopsy may have to be postponed for several months until the patient has become euthyroid and the bleeding diathesis has resolved (Smith & Auger, 1987).…”

mentioning

confidence: 99%

Effect of acute desmopressin and of long‐term thyroxine replacement on haemostasis in hypothyroidism

Erfurth

Ericsson

Egervall

et al. 1995

Clinical Endocrinology

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Summary OBJECTIVE Hypothyroidism can be complicated by bleeding symptoms such as easy bruising, menorrhagla and sometimes even a severe bleeding tendency with fatal outcome. Usually there is a prolonged bleeding time, or a low plasma concentration of coagulation factor VIII (FVIII) or von Willebrand factor (vWF). The aim of the present study was to investigate the acute haemostatic effect of desmopressin in hypothyroid patients. Another aim was to study the long‐term effect of thyroxine replacement on the plasma concentrations of coagulation factors and to ascertain the duration of thyroxine treatment needed to restore haemostatic function. DESIGN AND PATIENTS The effects of desmopressin, given intravenously over 10 minutes at a dosage of 0.3 μg/kg, and thyroxine treatment on haemostatic function were studied prospectively In 10 patients with hypothyroidism. RESULTS Before treatment only five of the patients manifested bleeding symptoms; one had prolonged bleeding time, and one had low plasma concentrations of vWF: Ag. Desmopressin virtually immediately reduced bleeding time, enhanced platelet adhesiveness, and significantly increased plasma concentrations of FVIII and vWF. The plasma concentrations of FVIII and vWF showed a significant increase after 4 months, whereas 7 months treatment with thyroxine was needed to reduce bleeding time significantly. CONCLUSION Our results suggest that in hypothyroid patients desmopressin may be of value for the acute treatment of bleeding or as cover for surgery.

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Hypothyroidism as a Cause of Acquired Von Wdllebrand's Disease

Cited by 134 publications

References 17 publications

Acquired von Willebrand Syndrome

Acquired von Willebrand Syndrome

Evaluation of the respective influence of thyroid hormones and TSH on blood coagulation parameters after total thyroidectomy

Effect of acute desmopressin and of long‐term thyroxine replacement on haemostasis in hypothyroidism

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