Yusuf

So it's just as ominous.

So it is diagnosed with an isolated elevated PTT and failure to correct with a mixing study.

And then von Willebrand's disease type 2N can mimic hemophilia or acquired hemophilia.

So you want to make sure that the von Willebrand's factor level is normal.

And then, like Mark said, it can be idiopathic or associated with autoimmune disease, malignancy, and advanced age.

And as you know, idiopathic means we just don't know yet.

We'll probably find out in the future.

Once this is diagnosed, this is an emergency.

These patients can bleed.

And I was talking to my friend who's a hematology fellow.

Whenever somebody has an acquired hemophilia, you actually go back to every single procedure they've gotten recently, and they're probably bleeding from that site.

So if they recently had a colonoscopy, they're probably bleeding from that colonoscopy.

Then IV, they're probably bleeding at that site of the IV, and the bleeding doesn't stop.

This is an emergency.

So you can check the Bethesda inhibitor titers to check the inhibitor level.

And then the treatment tells you how serious this is.

So you stop the bleeding.

So you give the recombinant factor 8.

But then you also want to eradicate the inhibitor.

And this is with way more than steroids.