Factor levels are undertaken – results show a reduced factor VIII levels, however all other factors are within normal range.

Von willibrands screen has therefore been requested.

Are there any other causes of reduced factor VIII levels in this patient?

Consider the management of this bleeding patient.  If he were to have a life threatening bleed could you suggest any treatment options?

Some suggestions have been made regarding acquired von willibrands – if confirmed what further investigations would you wish to perform in this patient?