The finding of elevated levels of endothelial adhesion proteins (E-selectin [ELAM-1], intercellular adhesion molecule-1 [ICAM-1] and von Willebrand factor [VWF]) and vascular cell adhesion molecule-1 [VCAM-1] in thalassemic patients suggested that endothelial injury or activation may be a feature of this genetic disease which also plays an important role in the recruitment of white blood cells and RBCs and promote thrombosis at vascular inflammation sites, vessel obstruction, tissue hypoxia and death17–22. The gene discussed is VWF; the disease is hereditary disease.