Acquired von Willebrand's disease may occur in patients with blood flow showing high shear rates. This is associated with loss of high molecular weight multimers of von Willebrand factor, which are important in hemostasis.
(4) severe arterial stenosis (atherosclerosis, other)
Features:
(1) The patient shows mucosal or other bleeding.
(2) Testing shows a loss of high molecular weight multimers.
(3) Correction of the high shear flow results in normal hemostasis and higher levels of high molecular weight multimers.
The patient should also be evaluated for other bleeding disorders since more than one condition may be present. This is important if hemostasis does not return to normal after correction of the high shear flow rate.
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