Knowledge Check

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

MGUS
Wilms tumor
Aortic stenosis
Essential thrombocythemia
Left ventricular assist device (LVAD)
SLE
MM
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.