Lagarrigue J, Richez B, Julliac B, Saltel L, Nurden P, Sztark F
Service d'anesthésie-réanimation I, hôpital Pellegrin, CHU de Bordeaux, 33076 Bordeaux, France.
Ann Fr Anesth Reanim. 2013 Jan;32(1):56-9. doi: 10.1016/j.annfar.2012.10.032. Epub 2012 Dec 5.
Type 2B von Willebrand disease (vWD) is an inherited bleeding syndrome resulting from a qualitative abnormality of von Willebrand Factor with an increased affinity for the glycoprotein Ib platelet receptor. Pregnancy increases the severity of this disease by decreasing the platelet count restricting epidural anaesthesia because of adverse risk of spinal bleeding. There is a phenotypic variability of Type 2B vWD depending of the von Willebrand Factor mutation. We report here the strategy we used to administer epidural anaesthesia for a patient with Type 2B vWD resulting from the P1337L mutation of von Willebrand Factor.