[Acquired von Willebrand's disease in the course of severe primary hypothyroidism in a patient with autoimmune polyglandular syndrome type 3].

The case of a 20-year old female, who had been followed because of von Willebrand disease (vWD) was presented in this paper . She had a past history of menorrhagia and bleeding after dental procedures and the activity of von Willebrand factor (vWF) was decreased. Because of suggestive clinical features, the workup for hypothyroidism was performed and the patient was found to have severe hypothyroidism due to Hashimoto thyroiditis. After the institution of replacement therapy with levothyroxine, von Willebrand factor activity returned to normal range and symptoms of von Willebrand disease disappeared. Based on these findings, the diagnosis of acquired von Willebrand syndrome (AvWS) due to hypothyroidism was made. The development of myasthenia led to the final diagnosis of autoimmune polyglandular syndrome type 3 (APS) with myasthenia gravis and vitiligo.

[1]  C. Stylianou,et al.  Acquired von Willebrand's syndrome resulting from untreated hypothyroidism in two prepubertal girls , 2006, Haemophilia : the official journal of the World Federation of Hemophilia.

[2]  J. Perheentupa Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. , 2006, The Journal of clinical endocrinology and metabolism.

[3]  A. Will Paediatric acquired von Willebrand Syndrome , 2006, Haemophilia : the official journal of the World Federation of Hemophilia.

[4]  K. Zaletel,et al.  Thyroid autoantibody production is influenced by exon 1 and promoter CTLA‐4 polymorphisms in patients with Hashimoto's thyroiditis , 2006, International journal of immunogenetics.

[5]  D. Kearney,et al.  Iron-Deficiency Anemia and Helicobacter pylori Infection: A Review of the Evidence , 2005, The American Journal of Gastroenterology.

[6]  M. Borzone,et al.  [Acquired von Willebrand disease as an unusual manifestation of primary hypothyroidism: report of two cases]. , 2005, Revista medica de Chile.

[7]  F. Lazzarotto,et al.  Autoimmune polyglandular syndrome Type 2: the tip of an iceberg? , 2004, Clinical and experimental immunology.

[8]  G. Eisenbarth,et al.  Autoimmune polyendocrine syndromes , 2004 .

[9]  G. Papi,et al.  Thyroid hemiagenesis and autoimmune polyglandular syndrome type III , 2003, Journal of endocrinological investigation.

[10]  G. Kahaly,et al.  Polyglandular autoimmune syndromes: immunogenetics and long-term follow-up. , 2003, The Journal of clinical endocrinology and metabolism.

[11]  Z. Berneman,et al.  Acquired von Willebrand syndromes: clinical features, aetiology, pathophysiology, classification and management. , 2001, Best practice & research. Clinical haematology.

[12]  J. Mendell,et al.  Myasthenia Gravis and Associated Autoimmune Diseases in Children , 2000, Journal of child neurology.

[13]  A. Sala,et al.  Proteolysis of von Willebrand Factor and Shear Stress–Induced Platelet Aggregation in Patients With Aortic Valve Stenosis , 2000, Circulation.

[14]  H. Mohri,et al.  Clinical significance of inhibitors in acquired von Willebrand syndrome. , 1998, Blood.

[15]  H. Hambley,et al.  Acquired von Willebrand's disease and hypothyroidism: report of a case presenting with menorrhagia. , 1990, Postgraduate medical journal.