Laboratory response to intranasal desmopressin in women with menorrhagia and platelet dysfunction.
Intranasal desmopressin (IN-DDAVP) is used for home treatment of menorrhagia in women with inherited bleeding disorders. The effect of IN-DDAVP on laboratory haemostatic parameters in women with menorrhagia related to platelet dysfunction is unknown. We evaluated the effects of IN-DDAVP on haemostatic parameters in women with menorrhagia and platelet dysfunction and correlated them with menstrual flow. Eleven women (aged 18-45) with menorrhagia and haemostatic abnormalities had determination of von Willebrand factor antigen (VWF:Ag), von Willebrand factor ristocetin cofactor (VWF:RCo) activity, factor VIII coagulant activity (FVIII:C), platelet aggregation and platelet adenosine tri-phosphate (ATP) release pre-IN-DDAVP and 60-min post-IN-DDAVP. Eight of eleven women underwent platelet function analyzer (PFA-100) closure time determination with collagen/adrenaline and collagen/adenosine diphosphate cartridges pretreatment and post-treatment. IN-DDAVP was administered during two consecutive menstrual cycles. Menstrual flow was assessed during each cycle using a pictorial blood assessment chart. Treatment with IN-DDAVP resulted in elevated VWF levels and shortened PFA-100 closure time with significant inverse correlation between shortening of PFA-100 closure times and increases in VWF levels. There were also significant inverse correlations between changes in menstrual flow and changes in VWF:Ag (P = 0.02), VWF:RCo (P = 0.04) and FVIII:C (P = 0.006), following treatment. In vitro platelet aggregation and platelet ATP release response did not correct and did not correlate with changes in menstrual flow. Our results demonstrate a correlation between haemostatic parameters and menstrual flow following IN-DDAVP in women with menorrhagia and platelet dysfunction.
Rose
S S
SS
Division of Hematology, Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA. rosesh@umdnj.edu
Faiz
A
A
Miller
C H
CH
Saidi
P
P
Philipp
C S
CS
D000255:Adenosine Triphosphate / Q000097:blood; D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D001760:Bleeding Time; D001791:Blood Platelet Disorders / Q000150:complications* / Q000453:epidemiology; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use*; D005169:Factor VIII / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008595:Menorrhagia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D012720:Severity of Illness Index; D014841:von Willebrand Factor / Q000187:drug effects* / Q000378:metabolism
D006490:Hemostatics; D014841:von Willebrand Factor; D000255:Adenosine Triphosphate; D005169:Factor VIII; D003894:Deamino Arginine Vasopressin