Laboratory response to intranasal desmopressin in women with menorrhagia and platelet dysfunction.

Abstract

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.

• Authors: S S Rose, A Faiz, C H Miller, P Saidi, C S Philipp
• Journal: Haemophilia : the official journal of the World Federation of Hemophilia (Haemophilia) Vol. 14 Issue 3 Pg. 571-8 (May 2008) ISSN: 1365-2516 [Electronic] England
• PMID: 18312366 (Publication Type: Journal Article)

Chemical References

• Hemostatics
• von Willebrand Factor
• Adenosine Triphosphate
• Factor VIII
• Deamino Arginine Vasopressin

Topics

• Adenosine Triphosphate (blood)
• Administration, Intranasal
• Adolescent
• Adult
• Bleeding Time
• Blood Platelet Disorders (complications, epidemiology)
• Deamino Arginine Vasopressin (pharmacology, therapeutic use)
• Factor VIII (drug effects, metabolism)
• Female
• Hemostatics (therapeutic use)
• Humans
• Menorrhagia (drug therapy, epidemiology, etiology)
• Middle Aged
• Platelet Aggregation (drug effects)
• Severity of Illness Index
• von Willebrand Factor (drug effects, metabolism)