A decrease in von Willebrand factor (VWF) protein synthesis or a decreased response to adrenergic stimulation (otherwise enhancing the VWF release from endothelial cells) due to the hormone deficiency are the most plausible mechanisms involved, as also supported by the finding of a reversal of the hypothyroidism-associated aVWS following thyroid hormone replacement [17]. The gene discussed is VWF; the disease is hypothyroidism.