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pubmed-article:11150026pubmed:abstractTextWe describe a von Willebrand disease (VWD) variant characterized by low plasma and platelet von Willebrand factor (VWF), impaired ristocetin-induced VWF binding to platelet glycoprotein Ib (GPIb), and abnormal VWF multimer pattern not associated with the absence of large forms. A C-to-T transition at nucleotide 4120 in exon 28 of the VWF gene was found; this mutation introduces a cysteine at the codon for Arg 611 of mature VWF. In addition to the decreased factor VIII (FVIII) and VWF levels, ristocetin-induced platelet aggregation (RIPA) was almost absent, and VWF ristocetin cofactor activity (VWF:RCo) was significantly more decreased than VWF antigen. The patients (mother and son) also showed a defect in VWF collagen-binding activity. Plasma VWF multimers were decreased, with no limit in the size of large forms, and the normal discontinuous multimer organization was replaced by a diffuse smear, especially detectable in the large forms. This picture was emphasized by 1-deamino-8-D -arginine vasopressin (DDAVP) infusion, so that the abnormal VWF multimers appeared to have a molecular weight higher than those present in, or released by, human umbilical vein endothelial cells. DDAVP also increased FVIII and VWF levels but did not normalize the GPIb-dependent VWF functions expressed as RIPA and VWF:RCo. We include this variant in type 2M VWD, focusing on the abnormality in GPIb-dependent VWF function. We advance that this defect depends on the mutation in the GPIb binding domain of VWF rather than the abnormal VWF multimer pattern.lld:pubmed
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pubmed-article:11150026pubmed:authorpubmed-author:GirolamiAAlld:pubmed
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pubmed-article:11150026pubmed:dateRevised2009-11-19lld:pubmed
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pubmed-article:11150026pubmed:year2001lld:pubmed
pubmed-article:11150026pubmed:articleTitleType 2M von Willebrand disease variant characterized by abnormal von willebrand factor multimerization.lld:pubmed
pubmed-article:11150026pubmed:affiliationDepartment of Medical and Surgical Sciences and the Second Chair of Internal Medicine, University of Padua Medical School, Italy.lld:pubmed
pubmed-article:11150026pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:11150026pubmed:publicationTypeCase Reportslld:pubmed
pubmed-article:11150026pubmed:publicationTypeResearch Support, Non-U.S. Gov'tlld:pubmed