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DR. ROCK:
      Normally, an enzyme, a metalloprotease, acts on those forms to form the normal kind of von Willebrand factor that goes around in the circulation. But in the presence of some patients, including the congenital ones, and in the series of Tsai and Furlan, they have found an inhibitor present in the plasma that blocks this conversion leaving them with these more active forms of von Willebrand factor circulating in the plasma.




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