eJHaem (Oct 2024)

Bleeding management in type 3 von Willebrand disease with anti‐von Willebrand factor inhibitor: A literature review and case report

  • Aurélie Briane,
  • Valérie Horvais,
  • Marianne Sigaud,
  • Marc Trossaërt,
  • Nicolas Drillaud,
  • Catherine Ternisien,
  • Marc Fouassier,
  • Antoine Babuty

DOI
https://doi.org/10.1002/jha2.984
Journal volume & issue
Vol. 5, no. 5
pp. 964 – 970

Abstract

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Abstract Treatment of type 3 von Willebrand disease by infusion of von Willebrand factor (VWF) and factor VIII (FVIII) concentrates may lead to the development of anti‐VWF antibodies, challenging haemostasis management. The systematic review of the literature presented here retrieved 15 such cases (surgery n = 11, bleeding n = 4). The heterogeneous patient management mostly involved continuous infusion of FVIII, or recombinant FVIIa together with various other strategies. Off‐label infusion of the bispecific monoclonal antibody emicizumab was prescribed in three cases and in a complex local case, ultimately well‐controlled with emicizumab. This illustrates the fact that emicizumab appears as a therapeutic option in this context of allo‐immunisation.

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