{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:34:24Z","timestamp":1760189664079,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2018,12,14]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Identification of acquired von Willebrand syndrome (AVWS) was key to treating a patient with chronic gastrointestinal (GI) bleeding due to angiodysplasia. After exhausting endoscopic and pharmacological options, the patient was successfully treated with rituximab. A 78-year-old man developed chronic GI bleeding from caecal and jejunal angiodysplasia. Red cell transfusion was required weekly despite argon plasma coagulation. A diagnosis of AVWS was made from analysis of clotting factors. Therapies including von Willebrand factor concentrate, thalidomide and tranexamic acid were unsuccessful. With failed endoscopic therapy and no viable surgical option, the patient was given intravenous immunoglobulins (IVIGs). Haemoglobin remained stable from this point. The impact on the patient and hospital of attending for IVIG every 3\u2009weeks necessitated consideration to longer-term therapy. After a single course of rituximab, no further blood products, IVIG or rituximab were required. This case is the first to describe the use of rituximab in AVWS-associated angiodysplasia.<\/jats:p>","DOI":"10.1136\/flgastro-2018-101116","type":"journal-article","created":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T17:19:20Z","timestamp":1547054360000},"page":"434-437","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Rituximab to the rescue: novel therapy for chronic gastrointestinal bleeding due to angiodysplasia and acquired von Willebrand syndrome"],"prefix":"10.1136","volume":"10","author":[{"given":"James","family":"Hawken","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Weston General Hospital, Weston-super-Mare, UK"},{"name":"Department of Hepatology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Knott","sequence":"additional","affiliation":[{"name":"Bristol Haematology Unit, University Hospitals Bristol NHS Foundation Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wesam","family":"Alsakkaf","sequence":"additional","affiliation":[{"name":"Department of Haematology, Weston General Hospital, Weston-super-Mare, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Clark","sequence":"additional","affiliation":[{"name":"Bristol Haematology Unit, University Hospitals Bristol NHS Foundation Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal","family":"Fayyaz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Weston General Hospital, Weston-super-Mare, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,9]]},"reference":[{"key":"2025090708492284000_10.4.434.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-11-297580"},{"key":"2025090708492284000_10.4.434.2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/jth.13551","article-title":"Von Willebrand factor and angiogenesis: basic and applied issues","volume":"15","author":"Randi","year":"2017","journal-title":"J Thromb Haemost"},{"key":"2025090708492284000_10.4.434.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2008.02909.x"},{"key":"2025090708492284000_10.4.434.4","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1111\/hae.12701","article-title":"Thalidomide for treatment of gastrointestinal bleedings due to angiodysplasia: a case report in acquired von Willebrand syndrome and review of the literature","volume":"21","author":"Engelen","year":"2015","journal-title":"Haemophilia"},{"key":"2025090708492284000_10.4.434.5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-12-023697"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2018-101116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T15:49:29Z","timestamp":1757260169000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2018-101116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,9]]},"references-count":5,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,9,6]]},"published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1136\/flgastro-2018-101116"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2018-101116","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"type":"print","value":"2041-4137"},{"type":"electronic","value":"2041-4145"}],"subject":[],"published":{"date-parts":[[2019,1,9]]}}}