{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T15:40:11Z","timestamp":1745595611007,"version":"3.40.4"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>Following diagnosis of acute lymphoblastic leukaemia (ALL) in a 10-year-old girl, routine coagulation screening including von Willebrand factor antigen (VWF:Ag), ristocetin cofactor activity (VWF:RCo) and factor VIIIC (FVIII:C) detected no pathological findings. After the first HR2\u2032 element of the high-risk group of the ALL-BFM 2000 protocol, the patient demonstrated extensive bleeding symptoms and acquired von Willebrand syndrome was diagnosed. VWF:Ag (13%), VWF:RCo (13%) and FVIII:C (27%) were decreased. Multimer analysis showed a loss of large multimers and a loss in triplet structures. The observed pattern was thought to be typical for monoclonal IgG gammopathy; however, in this case, unexpectedly, biclonal IgM gammopathy (\u03ba and \u03bb) was detected. After treatment with intravenous immunoglobulin over 5 days, coagulation factors increased to normal levels. Although this effect was assumed to be at best only temporary, especially in a case of IgM gammopathy, no further bleeding symptoms have been observed.<\/jats:p><jats:sec><jats:title>Trial registration number:<\/jats:title><jats:p>M208<\/jats:p><\/jats:sec>","DOI":"10.1136\/bcr.04.2009.1816","type":"journal-article","created":{"date-parts":[[2009,6,22]],"date-time":"2009-06-22T05:42:38Z","timestamp":1245649358000},"page":"bcr0420091816","source":"Crossref","is-referenced-by-count":2,"title":["Acquired von Willebrand syndrome in a 10-year-old girl with acute lymphoblastic leukaemia"],"prefix":"10.1136","volume":"2009","author":[{"given":"Isabel","family":"Dorn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Budde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael 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