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Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect.
  1. B. C. Chai,
  2. W. S. Etches,
  3. M. W. Stewart,
  4. K. Siminoski
  1. University of Alberta, Edmonton, Canada.


    We describe a man with adrenoleukodystrophy receiving Lorenzo's oil (glycerol trioleate and glycerol trierucate) who developed purpura, petechiae, and bleeding. Bleeding time was markedly increased (>20 min), although he had only borderline thrombocytopenia (120 x 10(9)/1) and conventional platelet aggregation studies were normal (except for a borderline response to low concentration collagen), as were results using a new technique employing immobilised von Willebrand factor. Together these results suggest that bleeding in this man resulted from a defect in vascular wall function or in the interaction of platelets with the endothelium.

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