Acquired type 2a von Willebrand's disease: response to immunoglobulin infusion

A 75-year-old male presented with new symptoms of a bleeding diathesis associated with a decline in the functional activity of von Willebrand factor (type 2a von Willebrand's disease). Replacement therapy was ineffective and he was subsequently treated with intravenous immunoglobulin (IvIg). IvIg not only caused symptomatic improvement but was shown to transiently restore the depleted von Willebrand factor intermediate and high molecular weight multimers. Subsequent periodic IvIg infusions have been used successfully to treat bleeding complications in this patient over the past 3 years. A secondary cause for the acquired von Willebrand's disease has not been identified.