後天性von Willebrand症候群患者の抜歯経験

• Published in: 日本口腔外科学会雑誌 Vol. 67; no. 7; pp. 459 - 463
• Main Authors: 坂倉, 寛紀, 兼子, 隆次, 岡部, 一登, 坂口, 晃平, 日比, 英晴, 澤木, 廉
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.07.2021
• Subjects: 出血管理; 後天性von Willebrand症候群; 抜歯; 第Ⅷ因子/vWF濃縮製剤，コンファクトF
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.67.459

A 42-year-old woman diagnosed with acquired von Willebrand syndrome (AvWS) was referred to our department for pain in the left mandibular third molar. vWF-containing concentrates (Confact F®) were transfused before and after tooth extraction for hemostatic management. Although initial hemostasis was achieved, persistent postoperative bleeding was observed 3 days later. Therefore, additional hemostatic management using a mouth splint with gingival packing and increased transfusion of Confact F® was required. After this, no further bleeding was observed, and the administration of Confact F® was ceased 14 days post-operation. The stitches were removed 24 days post-operation. Two years and 11 months after the operation, the clinical course is good. The pathophysiology of AvWS has not been elucidated, and an effective treatment has not yet been established. Therefore, reliable hemostatic management in cooperation with hematology is necessary.