title: Acquired von Willebrand disease and multiple myeloma: a case report of a breast cancer survivor.
abstract: Acquired von Willebrand disease (aVWD) is rare disease and is associated with a variety of underlying diseases. We report a case of aVWD in the setting of multiple myeloma. The patient was a 63-year-old female with breast cancer in remission who was admitted for symptomatic anemia. She was diagnosed with multiple myeloma. She also had subcutaneous bleeding before admission. Laboratory studies revealed isolated prolongation of the activated partial thromboplastin time, which corrected in a mixing study. Her factor VIII activity, von Willebrand factor (VWF) Ag, and VWF activity were low. VWF multimer study confirmed the patient had aVWD. The treatment of aVWD is discussed in this article, including the treatment of underlying diseases, and acute management in emergent situations. An intriguing question in this case is whether the patient's multiple myeloma is a chemotherapy-induced hematological malignancy or a second primary malignancy.
authors.affiliation: Department of Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland, USA.
authors.forename: Ning
authors.initials: N
authors.lastname: Jin
authors.forename: Farah F
authors.initials: FF
authors.lastname: Salahuddin
authors.forename: John A
authors.initials: JA
authors.lastname: Nesbitt
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D010314:Partial Thromboplastin Time; D010950:Plasma Cells / Q000473:pathology; D017741:Survivors; D016896:Treatment Outcome; D014842:von Willebrand Diseases / Q000097:blood* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D000970:Antineoplastic Agents; D014841:von Willebrand Factor; D005169:Factor VIII