title: Low dose danazol is effective in management of erythropoietin induced thrombosis.
abstract: Two patients (one male and one female) with end stage renal disease on chronic hemodialysis were treated with recombinant human erythropoietin (r-HuEPO). Both patients developed significant clotting in the vascular access and extracorporeal circuits. Coagulation studies indicated that both patients acquired high levels of tissue-type plasminogen activator inhibitor (PAI) with deficiency in tissue-type plasminogen activator (t-PA) and consequent impaired fibrinolysis. Their fibrinolytic activity was normalized with danazol therapy in doses as low as 2-4 mg/kg given orally once daily. We conclude that r-HuEPO-induced thrombosis is associated with impaired fibrinolysis due to acquired elevation of PAI which can be effectively prevented by small doses of danazol.
authors.affiliation: Department of Medicine, College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
authors.forename: A K
authors.initials: AK
authors.lastname: al-Momen
authors.forename: S O
authors.initials: SO
authors.lastname: Huraib
authors.forename: A M
authors.initials: AM
authors.lastname: Gader
authors.forename: F
authors.initials: F
authors.lastname: Sulaimani
mesh_terms: D000328:Adult; D003613:Danazol / Q000008:administration & dosage* / Q000627:therapeutic use; D004921:Erythropoietin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000188:drug therapy*; D008297:Male; D015849:Plasminogen Inactivators / Q000097:blood; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D013927:Thrombosis / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D015849:Plasminogen Inactivators; D011994:Recombinant Proteins; D004921:Erythropoietin; D003613:Danazol