A 28-year-old woman comes to the physician concerned about bleeding gum that she has been experiencing when she brushes her teeth. Her laboratory results show an increased partial thromboplastin time and an increased bleeding time, but are otherwise unremarkable. Which of the following treatments will most likely alleviate this patient’s symptoms?
B- Factor VIII concentrate
C- Fresh frozen plasma
D- Low-molecular-weight heparin
E- Protamine sulfate
[expand title=”CLICK HERE to view the correct answer:”][sociallocker]The correct answer is A. This woman suffers from von Willebrand’s disease, the most common inherited bleeding disorder; it results fro a defective form or overall deficiency of vWF. vWF has two functions: it serves as the ligand for platelet adhesion to a damaged vessel wall, and it also is the plasma carrier of factor VIII. Due to platelet dysfunction and lack of a carrier for factor VIII, the unique lab finding in this disease consists of an increased bleeding time and an increased partial thromboplastin time. Cryoprecipitate is the precipitate that remains when fresh frozen plasma is thawed. It contains sufficient normal vWF to correct the bleeding dyscrasia. In addition to prolonged bleeding from mucosal surfaces as in this patient, other symptoms include easy bleeding and skin bleeding.[/sociallocker][/expand]