title: An unusual case of abdominal arterial thrombosis in a young woman using desmopressin.
abstract: We report an unusual case of severe abdominal arterial thrombosis in a young woman using oral desmopressin. Only a few cases with cerebrovascular accidents and coronary syndromes have been described so far, which could be attributed to intravenous administration of desmopressin. Because extensive diagnostic and laboratory investigations for (un)common coagulation disorders could not identify an alternative explanation associated with arterial thrombosis, we hypothesise that desmopressin in an oral dose of at least 200 ug once daily must have been sufficient to cause this dramatic vascular complication. Supportive of our hypothesis, we found remarkably high levels of factor VIII activity, Von Willebrand factor (vWF) antigen and vWF ristocetin cofactor activity (268%, 740%, 590% respectively). To the best of the authors' knowledge, this is the first report suggesting a relationship between oral desmopressin use and life-threatening abdominal arterial thrombosis.
authors.affiliation: Tergooiziekenhuizen Hilversum, Department of Intensive Care, Van Riebeeckweg 212, 1213 XZ Hilversum, the Netherlands. ejm.schrijver@gmail.com
authors.forename: E J M
authors.initials: EJ
authors.lastname: Schrijver
authors.forename: W
authors.initials: W
authors.lastname: Deenik
authors.forename: H
authors.initials: H
authors.lastname: Chon
authors.forename: N
authors.initials: N
authors.lastname: Koedam
authors.forename: A M E
authors.initials: AM
authors.lastname: Spoelstra-de Man
mesh_terms: D015746:Abdominal Pain; D000328:Adult; D001778:Blood Coagulation Disorders / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology*; D003894:Deamino Arginine Vasopressin / Q000009:adverse effects* / Q000494:pharmacology; D004452:Echocardiography / Q000379:methods; D005169:Factor VIII / Q000096:biosynthesis; D005260:Female; D006490:Hemostatics / Q000494:pharmacology; D006801:Humans; D012310:Ristocetin / Q000097:blood; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D014841:von Willebrand Factor / Q000096:biosynthesis
chemical_list: D006490:Hemostatics; D014841:von Willebrand Factor; D012310:Ristocetin; D005169:Factor VIII; D003894:Deamino Arginine Vasopressin