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Related Experiment Videos

Effects of dextran 70 on factor VIII activity.

R H Raasch

    American Journal of Hospital Pharmacy
    |January 1, 1979
    PubMed
    Summary

    Dextran 70 therapy may reduce factor VIII activity in patients with thrombotic thrombocytopenic purpura (TTP). Monitoring factor VIII levels is recommended during dextran treatment to prevent hemostatic defects.

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    Area of Science:

    • Hematology
    • Pharmacology

    Background:

    • Thrombotic thrombocytopenic purpura (TTP) is a rare hematologic disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, and organ damage.
    • Dextran 70 is a plasma volume expander sometimes used in TTP management, but its potential effects on coagulation factors are not fully understood.

    Observation:

    • A case study involving a 24-year-old woman with TTP who experienced a significant decrease in factor VIII activity during dextran 70 infusion.
    • Factor VIII activity levels fluctuated, decreasing with dextran 70 administration and increasing upon its discontinuation, suggesting a direct association.

    Findings:

    • Dextran 70 administration was associated with a marked reduction in factor VIII activity, dropping from 14% to 82% after discontinuation and then from 75% to 29% upon re-administration.
    • The proposed mechanism involves dextran forming cryoprecipitates with fibrinogen (factor I) and factor VIII, thereby reducing factor VIII's functional activity.

    Implications:

    • This case highlights a potential iatrogenic complication of dextran 70 therapy, specifically the induction of acquired hemophilia A-like symptoms.
    • It suggests that patients receiving dextran therapy, particularly those with underlying hemostatic challenges like TTP, should be closely monitored for factor VIII activity and partial thromboplastin times.

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