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Thrombosis following desmopressin for uremic bleeding
J J Byrnes1, A Larcada, J L Moake
1Department of Medicine, University of Miami School of Medicine, Florida.
American Journal of Hematology
|May 1, 1988
Summary
Desmopressin (DDAVP) infusion may increase thrombosis risk in atherosclerosis patients. Unusually large von Willebrand factor (vWF) multimers, potentially induced by DDAVP, likely contributed to cerebral thrombosis in an elderly patient.
Area of Science:
- Cardiology
- Hematology
- Nephrology
Background:
- Atherosclerosis and uremic bleeding diathesis are known risk factors for thrombotic events.
- Desmopressin (DDAVP) is a synthetic analog of vasopressin used to treat bleeding disorders.
Observation:
- An elderly patient with atherosclerosis and uremia experienced two cerebral thromboses immediately post-DDAVP infusion.
- Plasma von Willebrand factor (vWF) analysis revealed unusually large vWF multimers following DDAVP administration.
Findings:
- The presence of unusually large vWF multimers induced by DDAVP infusion was observed.
- These large vWF multimers are known to cause platelet aggregation under high fluid shear stress, particularly in atherosclerotic vessels.
Implications:
- DDAVP may pose a thrombotic risk in patients with atherosclerosis.
- Caution is advised when administering DDAVP to patients with pre-existing atherosclerosis.
- Further investigation into DDAVP's effect on vWF multimer structure in at-risk populations is warranted.