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Blood, 2 April 2009, Vol. 113, No. 14, pp. 3348-3351. Prepublished online as a Blood First Edition Paper on December 5, 2008; DOI 10.1182/blood-2008-06-165233.
PLATELETS AND THROMBOPOIESIS The Montreal platelet syndrome kindred has type 2B von Willebrand disease with the VWF V1316M mutation1 Division of Hematology and Hematologic Malignancies, Department of Medicine, University of Calgary, Calgary, AB; 2 Calgary Health Region, Calgary, AB; 3 Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB; 4 Molecular Hematology, Calgary Laboratory Services, Calgary, AB; 5 Division of Hematology, Department of Medicine, Université Laval and CHA-Hôpital de l'Enfant-Jesus, Quebec City, QC; 6 Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON; and 7 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Montreal platelet syndrome (MPS), hitherto described in only one kindred, is a hereditary thrombocytopenia associated with mucocutaneous bleeding, giant platelets, and spontaneous platelet aggregation in vitro. These are features shared with some forms of type 2B von Willebrand disease (VWD); however, the MPS kindred had not been investigated for VWD. We found that all affected MPS family members had borderline to normal von Willebrand factor antigen (VWF:Ag; 0.43-0.75 U/mL), discrepantly low ristocetin cofactor activity (VWF:RCo; 0.16-0.29 U/mL), and normal factor VIII coagulant activity (FVIII:C; 0.57-1.04 U/mL). Unaffected family members all had normal VWF:Ag, VWF:RCo, and FVIII:C levels. In addition, persons with MPS, but not unaffected family members, had loss of plasma (but not platelet) high molecular weight VWF multimers, and were heterozygous for the previously reported V1316M type 2B VWD mutation. Thus, in reevaluating this kindred, we determined that patients with MPS have type 2B VWD with the V1316M VWF mutation.
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