Table 2.
Characteristics of two different ULVWF multimers
| mULVWF multimers | eULVWF multimers | |
|---|---|---|
| Synthesized in | Megakaryocytes | Endothelial cells |
| Stored in | α granules of platelets | Weibel-Palade bodies of ECs |
| Primary distribution at release | In circulation | On the membrane of ECs |
| Availability | In microcirculation | At ECs following endothelial exocytosis |
| Exposure to ADAMTS13 | As platelet-adherent form | As ECs-adherent form |
| Interaction with platelets causing | Platelet aggregation and adhesion | Platelet-ULVWF strings |
| Localization of platelet-ULVWF complexes | Arteriolar and capillary lumens lodged as microthrombi in situ | Endothelial membrane-anchored as microthrombi strings |
| Example of leading its activity | ADAMTS13 autoantibody | Sepsis-induced endotheliopathy |
| Endotheliopathic lesion | Microthrombotic microangiopathy | Microthrombotic angiopathy |
| Hematologic manifestation | Thrombocytopenia and MAHA | Thrombocytopenia and MAHA/aMAHA |
| Associated inflammation | None to minimal (?) | Mild to severe |
| Associated clinical syndrome | TTP | TTP-like syndrome |
ECs endothelial cells, eULVWF/mULVWF endothelial unusually large von Willebrand factor/megakaryocytic ULVWF, MAHA/aMAHA microangiopathic hemolytic anemia/atypical MAHA, TTP thrombotic thrombocytopenic purpura