An experience of extraction of a tooth in the patient with von willebrand's disease

Abstract

Von Willebrand's disease is a coagulation disorder caused by the insufficient activity of von Willebrand factor. The hemostatic management for tooth extraction in the patient with von Willebrand's disease is described.
The patient, a 28 year old female was referred to our clinic to have a tooth extracted. Ten units of commercially obtained cryoprecipitates preraration (AHF) per kg body weight was given preoperatively, additionally 10 units per kg was administered after 24 hours just at bleeding and no further bleeding was detected. The blood level of VIII R: WF was 20% at the beginning and VIII R: WF was elevated to 60% at 60 minutes after infusion and returned to preinfusion level after 24 hours. However the patient developed serum hepatitis about a month later.
On the other hand, in addition to von Willebrand's disease the patient had membranous lipodystrophy for 8 years, which is apparently a new disease of symmetrically degenerative changes in the bones of the extremities, which seems to progress slowly with age. The etiology of this disease is unknown and a hereditary factor is suggested.
Relations between von Willebrand's disease and membranous lipodystrophy have not been studied enough and are yet to be clarified.