Although immune tolerance induction (ITI) is recommended in hemophilia A patients with FVIII inhibitors,30, 31there is no standardized approach to ITI in VWD patients with VWF inhibitors.32ITI with wilate has been described previously in two brothers with type 3 VWD who developed VWF inhibitors. The gene discussed is VWF; the disease is von Willebrand disease 3.