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Effect of acute desmopressin and of long-term thyroxine replacement on haemostasis in hypothyroidism

Erfurth, E M LU ; Ericsson, U B ; Egervall, Karin and Lethagen, S R LU (1995) In Clinical Endocrinology 42(4). p.8-373
Abstract

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.

DESIGN AND PATIENTS: The effects of desmopressin, given intravenously over 10 minutes at a dosage... (More)

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.

DESIGN AND PATIENTS: 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.

CONCLUSION: Our results suggest that in hypothyroid patients desmopressin may be of value for the acute treatment of bleeding or as cover for surgery.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult, Aged, Bleeding Time, Deamino Arginine Vasopressin/pharmacology, Factor VIII/metabolism, Female, Hemostasis/drug effects, Humans, Hypothyroidism/blood, Male, Middle Aged, Platelet Adhesiveness/drug effects, Platelet Count, Prospective Studies, Thyrotropin/blood, Thyroxine/blood, Time Factors, Triiodothyronine/blood, von Willebrand Factor/metabolism
in
Clinical Endocrinology
volume
42
issue
4
pages
8 - 373
publisher
Wiley-Blackwell
external identifiers
  • scopus:0028904602
  • pmid:7750191
ISSN
0300-0664
DOI
10.1111/j.1365-2265.1995.tb02645.x
language
English
LU publication?
yes
id
065779fe-8dbe-459e-a0e1-3d916c713c95
date added to LUP
2023-11-27 09:46:06
date last changed
2024-01-10 11:53:00
@article{065779fe-8dbe-459e-a0e1-3d916c713c95,
  abstract     = {{<p>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.</p><p>DESIGN AND PATIENTS: 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.</p><p>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.</p><p>CONCLUSION: Our results suggest that in hypothyroid patients desmopressin may be of value for the acute treatment of bleeding or as cover for surgery.</p>}},
  author       = {{Erfurth, E M and Ericsson, U B and Egervall, Karin and Lethagen, S R}},
  issn         = {{0300-0664}},
  keywords     = {{Adult; Aged; Bleeding Time; Deamino Arginine Vasopressin/pharmacology; Factor VIII/metabolism; Female; Hemostasis/drug effects; Humans; Hypothyroidism/blood; Male; Middle Aged; Platelet Adhesiveness/drug effects; Platelet Count; Prospective Studies; Thyrotropin/blood; Thyroxine/blood; Time Factors; Triiodothyronine/blood; von Willebrand Factor/metabolism}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{8--373}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Clinical Endocrinology}},
  title        = {{Effect of acute desmopressin and of long-term thyroxine replacement on haemostasis in hypothyroidism}},
  url          = {{http://dx.doi.org/10.1111/j.1365-2265.1995.tb02645.x}},
  doi          = {{10.1111/j.1365-2265.1995.tb02645.x}},
  volume       = {{42}},
  year         = {{1995}},
}