Knowledge Check

Sort the causes of acquired von Willebrand syndrome (top) according to mechanisms (bottom):

Essential thrombocythemia
SLE
MGUS
MM
Left ventricular assist device (LVAD)
Wilms tumor
Aortic stenosis
Shearing of HMW multimers
Antibody-mediated vWF clearance
Increased binding of vWF to cells

Abbreviations: vWF, von Willebrand factor; HMW, high molecular weight; MM, multiple myeloma, MGUS, monoclonal gammopathy of unknown significance; SLE, systemic lupus erythematosus.

Most cases of acquired von Willebrand syndrome, including those caused by increased shear stress and increased binding to cells, involve a reduction in high molecular weight von Willebrand multimers.

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