20:T45b,Pharmacologic studies¹of benzedrine (beta-aminopropylbenzene or benzyl methyl carbinamine) indicate that it has a sympathomimetic action and a profound stimulating effect on the central nervous system. Clinically its sympathomimetic action has been utilized particularly in the treatment of congestion of the nasal mucosa,²in maintaining blood pressure during spinal anesthesia³and in orthostatic hypotension,⁴and for the relief of spasm affecting the gastro-intestinal tract.⁵The stimulating effect on the central nervous system has led to observations on the effect of benzedrine in many psychiatric and neurologic conditions, including narcolepsy,⁶disorders of mood and affect (chiefly depression⁷), postencephalitic parkinsonism,⁸psychoneurosis,⁹and to observations on its effect on normal persons and on those¹⁰suffering from states of exhaustion.¹¹ The method by which benzedrine produces a stimulating action on the central nervous system and the part of the brain which it stimulates is21:T46d,Acquired von Willebrand syndrome is a rare bleeding disorder characterised by a later age of onset without a personal or family history of bleeding diathesis. It is vital to discern acquired von Willebrand syndrome from inherited von Willebrand disease and other acquired bleeding disorders as management differs significantly. Acquired von Willebrand syndrome is usually secondary to an underlying disorder such as lymphoproliferative disorder, myeloproliferative neoplasm, solid tumour, cardiovascular disorder, autoimmune disorders or hypothyroidism. Diagnosis is often delayed with a significant risk of morbidity and even mortality. Here we present a case of a 74-year-old man with an acquired bleeding disorder and work up suggestive of acquired von Willebrand syndrome secondary to immunoglobulin G kappa multiple myeloma. He was treated successfully with intravenous immunoglobulin, von Willebrand Factor/Coagulation Factor VIII Complex (human), myeloma directed chemotherapy and autologous stem cell transplantation. We also discuss the management strategies that are largely based on retrospective studies and case reports.

	Year	Citations

Abstract

References