Potential mechanisms have been explored: serum levels of the anticoagulant pathway cofactor thrombomodulin transiently dropped during the first month of thalidomide therapy, with gradual recovery over the following two months [7]; patients with MM treated with thalidomide had extremely high levels of von Willebrand factor antigen and factor VIII, factors known to be associated with an increased risk of thrombotic events in the general population [8]. Here, THBD is linked to Miyoshi myopathy.