Effect of acute desmopressin and of long-term thyroxine replacement on haemostasis in hypothyroidism.
OBJECTIVE
Hypothyroidism can be complicated by bleeding symptoms such as easy bruising, menorrhagia and sometimes even a severe bleeding tendency with fatal outcome. Usually there is a prolonged bleeding time, or a low plasma concentration of coagulation factor VIII (FVIII) or von Willebrand factor (vWF). The aim of the present study was to investigate the acute haemostatic effect of desmopressin in hypothyroid patients. Another aim was to study the long-term effect of thyroxine replacement on the plasma concentrations of coagulation factors and to ascertain the duration of thyroxine treatment needed to restore haemostatic function.


METHODS
The effects of desmopressin, given intravenously over 10 minutes at a dosage of 0.3 micrograms/kg, and thyroxine treatment on haemostatic function were studied prospectively in 10 patients with hypothyroidism.


RESULTS
Before treatment only five of the patients manifested bleeding symptoms; one had prolonged bleeding time, and one had low plasma concentrations of vWF:Ag. Desmopressin virtually immediately reduced bleeding time, enhanced platelet adhesiveness, and significantly increased plasma concentrations of FVIII and vWF. The plasma concentrations of FVIII and vWF showed a significant increase after 4 months, whereas 7 months treatment with thyroxine was needed to reduce bleeding time significantly.


CONCLUSIONS
Our results suggest that in hypothyroid patients desmopressin may be of value for the acute treatment of bleeding or as cover for surgery.
Erfurth
E M
EM
University of Lund, Department of Medicine, University Hospital, Sweden.
Ericsson
U B
UB
Egervall
K
K
Lethagen
S R
SR
D000328:Adult; D000368:Aged; D001760:Bleeding Time; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology*; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D007037:Hypothyroidism / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010973:Platelet Adhesiveness / Q000187:drug effects; D010976:Platelet Count; D011446:Prospective Studies; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism
D014841:von Willebrand Factor; D014284:Triiodothyronine; D005169:Factor VIII; D013972:Thyrotropin; D003894:Deamino Arginine Vasopressin; D013974:Thyroxine