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Case Reports in Oncological Medicine
Volume 2017, Article ID 9295780, 3 pages
https://doi.org/10.1155/2017/9295780
Case Report

Acquired von Willebrand Disease Associated with Monoclonal Gammopathy of Unknown Significance

1Department of Medicine, Reading Hospital, 420 S. Fifth Avenue, West Reading, PA 19611, USA
2Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal

Correspondence should be addressed to Sijan Basnet; gro.htlaehgnidaer@tensab.najis

Received 1 August 2017; Accepted 16 October 2017; Published 1 November 2017

Academic Editor: Josep M. Ribera

Copyright © 2017 Sijan Basnet et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a case of a 79-year-old male who presented with retroperitoneal hematoma a week after motor vehicle accident. Prior history and family history of bleeding were nonsignificant. His activated partial thromboplastin time was found to be prolonged in the emergency department. Further workup with coagulation studies showed decreased factor VIII, vWF antigen, and vWF:ristocetin cofactor assay, and negative Bethesda assay, indicating acquired von Willebrand disease. Immunofluorescence to find an underlying etiology was suggestive of MGUS. Management of AvWD depends on controlling active bleeding and treating the underlying cause. He was treated with factor VIII, haemate-p, rituximab, two cycles of IVIg, and three weeks of oral steroids.