Treatment of recurrent gastrointestinal haemorrhage in a patient with von Willebrand’s disease with octreotide LAR and propranolol

Von Willebrand’ s disease (vWD) is the most common inherited bleeding disorder and is caused by quantitative deficiency or qualitative abnormalities of von Willebrand factor (vWF). Until recently, treatment of bleeding from the gastrointestinal tract in patients with vWD included administration of tranexamic acid or clotting factor products such as fresh frozen plasma, cryoprecipitate, purified vWF concentrates, or preparations that contain vWF and factor VIII. Desmopressin, beta blocking drugs, and hormonal therapy with oestrogen with or without progesterone have also been used.1,2 We report a patient with vWD who had suffered recurrent and life threatening bleeding from the gastrointestinal tract in whom, despite an extensive investigation, no apparent cause of haemorrhage was identified. He was successfully treated with combined administration of octreotide LAR (long active released) and propranolol. This is the first report on the use of octreotide LAR in a patient with vWD. A …