The replacement therapy of AHG on hemorrhagic episode in hemophilia A patients have faced several troublesome complications, i.e., appearance of inhibitor, hepatitis and allergic reaction.
After obtaining that 1-Deamino-8-D-Arginine Vasopressin (DDAVP) increased factor VIII activity in normal subjects, the usefulness of this drug to these patients was evaluated.
Intravenous infusion of 10μg DDAVP to seven normal subjects and to four mild hemophilia A patients were monitored serially by coagulation and fibrinolysis studies. In normal subjects, factor VIII activity increased from 2 to 5 times, factor VIII antigen from 1.6 to 2.7 times. In four mild hemophiliacs, factor VIII activity increased from 2.2 to 3.3 times. Because the plasminogen activator increments were observed in both normal and hemophiliacs, antiplasmic agent to block the fibrinolytic activity was accompanied to the DDAVP infusion (0.4 g/Kg, every 12 hours) in clinical practice. For gastrectomy, AHG was used in addition to the DDAVP to supply the factor VIII level needed for major operation.
For tooth-extraction, only DDAVP was used. In both cases, the hemostatic effect of this DDAVP was prominent and satisfactory.
On the 5th operation day, however, hyponatremia was observed and DDAVP was withdrawn.
DDAVP appeared to be a very useful tool in controlling hemostasis in mild hemophiliacs in hyponatremia was carefully watched.
