Thromb Haemost 1988; 59(02): 221-224
DOI: 10.1055/s-0038-1642758
Original Articles
Schattauer GmbH Stuttgart

Patients With Prolonged Bleeding Time of Undefined Etiology, and Their Response to Desmopressin

Hugh C Kim
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
,
Kathryn Salva
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
,
Paul L Fallot
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
,
George I Karp
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
,
Joan Eisele
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
,
Linda Matts
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
,
Ilana Heller
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
,
Parvin Saidi
The Division of Hematology-Oncology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Rutgers University College of Pharmacy, Piscataway, New Jersey, USA
› Author Affiliations
Further Information

Publication History

Received 01 July 1987

Accepted after revision 27 November 1987

Publication Date:
31 May 2018 (online)

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Summary

Between 1981 and 1986, we evaluated 59 patients who presented with isolated prolongation of bleeding time with normal platelet counts, platelet aggregation and coagulation parameters (including von Willebrand’s factor), and without evidence of liver or kidney disease, or exposure to anti-platelet agents. These patients, termed as vascular fragility syndrome (VFS), were analyzed to further characterize their bleeding patterns. The pattern of bleeding manifestations was similar to that of patients with platelet dysfunction, such as mucocutaneous bleeding or excessive post-operative bleeding. In 16 patients, desmopressin (l-desamino-8-d-arginine vasopressin, DDAVP) was infused to control active bleeding or as a part of pre-surgical evaluation. Bleeding time improved (pre-DDAVP bleeding time 15.3 ± 3.4 min, mean±S.D.; post-DDAVP bleeding time 10.7 ± 3.9 min; p<0.01) within 30 minutes following the DDAVP infusion with either satisfactory arrest of acute bleeding or good control of subsequent hemostasis with surgery. Side effects with DDAVP were transient and minor, i.e. facial flushing, or conjunctival erythema. These findings indicate that VFS with isolated prolongation of bleeding time is a frequently encountered bleeding disorder and that DDAVP is effective in achieving hemostasis for the management of acute bleeding and may be useful prior to surgical procedures.