Hematological Disorder in Patients With Angiodysplasia

Angiodysplasia is a vascular GI tract abnormality tortous thin walled blood vessels seen in mucosa and submucosa highly prone to rupture resulting in GIT bleeding and hematological disorders ,Impaired coagulation profile and anemia are main changes in angiodysplasia . (An overview of angiodysplasia: management and patient prospects,Grainne Holleran et al. Expert Rev Gastroenterol Hepatol. 2018 Sep.) Gastrointestinal angiodysplasia is a major cause of recurrent bleeding. Haemostatic abnormalities have been implicated in the haemorrhage from these common vascular lesions but their precise contribution remains to be established. (Gastrointestinal angiodysplasiaG Dodda et al. J Assoc Acad Minor Phys. 1997) Angiodyplasia and aortic stenosis are both conditions that are highly prevalent in elderly people and can often co-exist. Recent studies suggest that this association is related to subtle alterations in plasma coagulation factors . The von Willebrand factor is the strongest link between aortic stenosis and bleeding associated with gastrointestinal angiodysplasia. With an aging population, the disease burden of aortic stenosis and its association with angiodysplasia of the bowel makes this an incredibly under-diagnosed yet important condition. This association when dealing with elderly patients presenting either with unexplained anemia, gastrointestinal bleeding or with aortic stenosis should be considered. A high index of suspicion and appropriate diagnostic techniques followed by appropriate and prompt treatment could be life-saving. (Heyde Syndrome Complicated by Essential Thrombocythemia: A Case Report) Chronic hematologic diseases increase the fragility of blood cell components, leading to the progressive destruction of blood cells at the site of aortic stenosis . In this process, further destruction of large multimers of von Willebrand factor may lead to coagulation disorders and gastrointestinal bleeding, such as Heyde syndrome.