The Effect of Desmopressin on Massive Gastrointestinal Bleeding in Hereditary Telangiectasia Unresponsive to Treatment With Cryoprecipitate

Miriam Quitt, Paul Froom, Alexander Veisler, Vera Falber, Janina Sova, Esther Aghai

Research output: Contribution to journalArticlepeer-review

Abstract

A patient with hereditary hemorrhagic telangiectasia and reduced levels of von Willebrand factor had severe recurrent gastrointestinal bleeding. Treatment with either desmopressin acetate or cryoprecipitate normalized both bleeding time and kaolin-activated partial thromboplastin time. Hematochezia (five episodes) continued, however, for a week despite daily treatment with cryoprecipitate, whereas treatment with desmopressin at the onset of three later episodes of hematochezia resulted in the prompt cessation of bleeding. After an episode of life-threatening gastrointestinal bleeding, desmopressin administration allowed a total colectomy without excessive bleeding. During the 3 years after colectomy, no further gastrointestinal bleeding occurred. In the past year, however, three episodes of severe epistaxis responded promptly to intravenous infusion of desmopressin. We conclude that desmopressin may be useful in the management of bleeding in patients with hereditary hemorrhagic telangiectasia with or without von Willebrand factor deficiency.

Original languageEnglish
Pages (from-to)1744-1746
Number of pages3
JournalArchives of Internal Medicine
Volume150
Issue number8
DOIs
StatePublished - Aug 1990
Externally publishedYes

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