Case 79 – update 1

So we have an update

Our patient has presented with a long history of epistaxis.

There is no history of easy bruising. 

No bleeding after tooth extraction

Her mother died of a brain haemorrhage and also had significant history of epistaxis. The patient also thinks her maternal grandfather had significant history of epistaxis and gi bleeds, and needed several blood transfusions.

On examination, no hepatosplenomegally, no visible oral telangegtasia although there do appear to be several cutaneous telangectasia on the hands.

Fbc shows a microcytic hypochromic anaemia. Ferritin 5.

Pt 13

Aptt 27

Claus fib 4.0

Vwd screen 

Factor VIII 160%

Vw antigen 130%

VW activity 120%

RICOF 130%

Platelet function test normal

What are the thoughts now?

Are there any other investigations you would like? 

Join us on Twitter @TeamHaem and let us know what your thoughts are, what questions you have and what you want to do as we see this case evolve over the next week. Remember to use #teamhaem on all your posts to help us follow the case! Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality. TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Inherited bleeding and tagged , , . Bookmark the permalink.