AB199. A perioperative challenge: acquired von Willebrand disease secondary to IgG lambda monoclonal gammopathy of undetermined significance (MGUS) in oesophageal cancer

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Background: Acquired von Willebrand disease (AVWD) is a rare acquired bleeding disorder with 0.04% prevalence. It can be distinguished from von Willebrand disease (vWD) by lack of personal or familial history of bleeding diathesis. Resulting in reduction of plasma von Willebrand factor (vWF), it can be associated with a number of acquired conditions including haematoprolifierative, cardiovascular, autoimmune disorders and neoplasia. Several mechanisms are described, including increased clearance of vWF secondary to autoantibodies, non-specific antibodies, adsorption onto malignant cells and shear stress.