Reactions 1096 - 8 Apr 2006

SDesmopressin

Relapse of thrombotic thrombocytopenic purpura ina child: case report

Desmopressin therapy for nocturnal enuresis in a 6-year-oldgirl was associated with a relapse of inherited thromboticthrombocytopenic purpura (TTP), also called Upshaw-Schulman syndrome.

Several weeks after beginning treatment with intranasaldesmopressin every evening [dosage not stated], the girl washospitalised with her seventh relapse of TTP. All previous acuteepisodes had been associated with infections, but there wereno obvious triggers for the current episode.

The girl was treated with plasma infusions anddesmopressin was discontinued. Attempts to create asubcutaneous radial arteriovenous fistula to administerpreventive monthly plasma infusions were unsuccessfulbecause of recurrent local thrombosis. Clinical remission ofTTP was achieved in 2 weeks. During a 4-year follow-upperiod, she did not experience any relapses of TTP.

Author comment: "[D]esmopressin was very likely theunexpected triggering factor of the current TTP relapse, andmaybe also of vascular access thrombosis."Veyradier A, et al. Desmopressin, an unexpected link between nocturnal enuresisand inherited thrombotic thrombocytopenic purpura. (Upshaw-Schulmansyndrome). Journal of Thrombosis and Haemostasis 4: 700-701, No. 3, Mar 2006 -France 801013435

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Reactions 8 Apr 2006 No. 10960114-9954/10/1096-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved