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Persistent Gastrointestinal Angiodysplasia in Heyde's Syndrome after Aortic Valve Replacement.
Intern Med. 2017 Sep 15; 56(18):2431-2433.IM

Abstract

A 67-year-old woman with recurrent gastrointestinal bleeding and aortic valve stenosis presented with spurting bleeding from angiodysplasia of the upper jejunum. As electrophoresis revealed decreased levels of high-molecular-weight (HMW) von Willebrand factor (VWF) multimers, she was diagnosed with Heyde's syndrome. After aortic valve replacement, her HMW VWF levels quickly recovered to normal, and the gastrointestinal bleeding ceased. However, capsule endoscopy still revealed gastrointestinal angiodysplasia six months later. This case shows that minute analyses of VWF multimers enable the diagnosis and confirmation of the resolution of Heyde's syndrome, and implies that gastrointestinal angiodysplasia can be attributed to unknown factors other than decreased VWF multimers.

Authors+Show Affiliations

Department of Internal Medicine and Gastrointestinal Endoscopy, Saga University School of Medicine, Japan.Department of Hematology, Respiratory Medicine and Oncology, Saga University School of Medicine, Japan.Department of Internal Medicine and Gastrointestinal Endoscopy, Saga University School of Medicine, Japan.Department of Transfusion Medicine, Nara Prefectural Medical College, Japan.Department of Hematology, Respiratory Medicine and Oncology, Saga University School of Medicine, Japan.Department of Internal Medicine and Gastrointestinal Endoscopy, Saga University School of Medicine, Japan.Department of Internal Medicine and Gastrointestinal Endoscopy, Saga University School of Medicine, Japan.Department of Internal Medicine and Gastrointestinal Endoscopy, Saga University School of Medicine, Japan.Department of Thoracic and Cardiovascular Surgery, Saga University School of Medicine, Japan.Department of Thoracic and Cardiovascular Surgery, Saga University School of Medicine, Japan.Department of Thoracic and Cardiovascular Surgery, Saga University School of Medicine, Japan.Department of Internal Medicine and Gastrointestinal Endoscopy, Saga University School of Medicine, Japan.Department of Hematology, Respiratory Medicine and Oncology, Saga University School of Medicine, Japan.Department of Transfusion Medicine, Nara Prefectural Medical College, Japan.Department of Internal Medicine and Gastrointestinal Endoscopy, Saga University School of Medicine, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28824071

Citation

Akutagawa, Takashi, et al. "Persistent Gastrointestinal Angiodysplasia in Heyde's Syndrome After Aortic Valve Replacement." Internal Medicine (Tokyo, Japan), vol. 56, no. 18, 2017, pp. 2431-2433.
Akutagawa T, Shindo T, Yamanouchi K, et al. Persistent Gastrointestinal Angiodysplasia in Heyde's Syndrome after Aortic Valve Replacement. Intern Med. 2017;56(18):2431-2433.
Akutagawa, T., Shindo, T., Yamanouchi, K., Hayakawa, M., Ureshino, H., Tsuruoka, N., Sakata, Y., Shimoda, R., Noguchi, R., Furukawa, K., Morita, S., Iwakiri, R., Kimura, S., Matsumoto, M., & Fujimoto, K. (2017). Persistent Gastrointestinal Angiodysplasia in Heyde's Syndrome after Aortic Valve Replacement. Internal Medicine (Tokyo, Japan), 56(18), 2431-2433. https://doi.org/10.2169/internalmedicine.8603-16
Akutagawa T, et al. Persistent Gastrointestinal Angiodysplasia in Heyde's Syndrome After Aortic Valve Replacement. Intern Med. 2017 Sep 15;56(18):2431-2433. PubMed PMID: 28824071.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistent Gastrointestinal Angiodysplasia in Heyde's Syndrome after Aortic Valve Replacement. AU - Akutagawa,Takashi, AU - Shindo,Takero, AU - Yamanouchi,Kohei, AU - Hayakawa,Masaki, AU - Ureshino,Hiroshi, AU - Tsuruoka,Nanae, AU - Sakata,Yasuhisa, AU - Shimoda,Ryo, AU - Noguchi,Ryo, AU - Furukawa,Kojiro, AU - Morita,Shigeki, AU - Iwakiri,Ryuichi, AU - Kimura,Shinya, AU - Matsumoto,Masanori, AU - Fujimoto,Kazuma, Y1 - 2017/08/21/ PY - 2017/8/22/pubmed PY - 2018/3/20/medline PY - 2017/8/22/entrez KW - Heyde's syndrome KW - gastrointestinal angiodysplasia KW - von Willebrand factor SP - 2431 EP - 2433 JF - Internal medicine (Tokyo, Japan) JO - Intern. Med. VL - 56 IS - 18 N2 - A 67-year-old woman with recurrent gastrointestinal bleeding and aortic valve stenosis presented with spurting bleeding from angiodysplasia of the upper jejunum. As electrophoresis revealed decreased levels of high-molecular-weight (HMW) von Willebrand factor (VWF) multimers, she was diagnosed with Heyde's syndrome. After aortic valve replacement, her HMW VWF levels quickly recovered to normal, and the gastrointestinal bleeding ceased. However, capsule endoscopy still revealed gastrointestinal angiodysplasia six months later. This case shows that minute analyses of VWF multimers enable the diagnosis and confirmation of the resolution of Heyde's syndrome, and implies that gastrointestinal angiodysplasia can be attributed to unknown factors other than decreased VWF multimers. SN - 1349-7235 UR - https://www.unboundmedicine.com/medline/citation/28824071/Persistent_Gastrointestinal_Angiodysplasia_in_Heyde's_Syndrome_after_Aortic_Valve_Replacement_ L2 - https://dx.doi.org/10.2169/internalmedicine.8603-16 DB - PRIME DP - Unbound Medicine ER -