title: Acquired von Willebrand syndrome in multiple myeloma.
abstract: Acquired von Willebrand syndrome (AvWS) is an uncommon complication of multiple myeloma (MM), and it is believed to be connected with paraprotein. The aim of this study was to determine the incidence of AvWS in patients with MM, and estimate the role of paraprotein in its occurrence. The study included 40 patients with MM. The plasma level of paraprotein, platelet adhesion on glass pearls, plasma von Willebrand factor antigen concentration, and ristocetin-induced platelet aggregation (RIPA) were measured initially. Absence of RIPA was found in six patients with MM (15%); however, all six of them had normal levels of von Willebrand factor antigen. Paraprotein was isolated from the serum of these patients. Platelet aggregation was measured in six healthy donors before and after addition of the isolated paraprotein. RIPA was significantly decreased in healthy donors in the presence of paraprotein (P<0·001). The same test was repeated with added human immunoglobulins for intravenous use without any change in RIPA. A significant negative correlation between plasma paraprotein level and RIPA was found (P<0·001). These investigations have shown that paraprotein is associated with AvWS in patients with MM.
authors.affiliation: Clinic for Haematology, Clinical Center of Serbia, Belgrade, Serbia. irenadju@eunet.rs
authors.forename: Irena
authors.initials: I
authors.lastname: Djunic
authors.forename: Ivo
authors.initials: I
authors.lastname: Elezovic
authors.forename: Vesna
authors.initials: V
authors.lastname: Ilic
authors.forename: Dragica
authors.initials: D
authors.lastname: Tomin
authors.forename: Nada
authors.initials: N
authors.lastname: Suvajdzic-Vukovic
authors.forename: Jelena
authors.initials: J
authors.lastname: Bila
authors.forename: Darko
authors.initials: D
authors.lastname: Antic
authors.forename: Ana
authors.initials: A
authors.lastname: Vidovic
authors.forename: Nadezda
authors.initials: N
authors.lastname: Milosevic-Jovcic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001780:Blood Coagulation Tests / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000150:complications* / Q000473:pathology; D010266:Paraproteins / Q000378:metabolism; D010974:Platelet Aggregation / Q000187:drug effects; D012310:Ristocetin / Q000008:administration & dosage; D014842:von Willebrand Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology
chemical_list: D010266:Paraproteins; D012310:Ristocetin