Platelet aggregation and pseudothrombocytopenia induced by 1-desamino-8-D-arginine vasopressin (DDAVP) in type IIB von Willebrand's disease patient

Eur J Haematol. 1990 Jul;45(1):36-42. doi: 10.1111/j.1600-0609.1990.tb00412.x.


Our study shows that the thrombocytopenia described in type IIB von Willebrand's disease (vWd) after 1-desamino-8-D-arginine vasopressin (DDAVP) infusion is, at least partially, a pseudothrombocytopenia. There was a discrepancy in platelet counts in blood anticoagulated with EDTA (less than 10 x 10(3)/microliters) or citrate (55 x 10(3)/microliters) in one patient with type IIB vWd and chronic thrombocytopenia (80 x 10(3)/microliters) after DDAVP infusion. Furthermore, DDAVP induced a normalization of patient's prolonged bleeding time. Spontaneous platelet aggregation (SPA) observed in platelet-rich plasma before DDAVP infusion was inhibited completely by monoclonal antibodies which block binding of fibrinogen, vWf and fibronectin to GPIIb-IIIa. SPA was partially inhibited by a monoclonal antibody which blocks the binding of vWf to GPIb. After DDAVP, in contrast, SPA partially persisted in the presence of anti-GPIIb-IIIa monoclonal antibodies but was completely inhibited by anti-GPIb monoclonal antibody. Therefore GPIb and GPIIb-IIIa complex seem to play a different role in SPA before and after DDAVP infusion into type IIB vWd.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal / pharmacology
  • Anticoagulants
  • Bleeding Time
  • Blood Platelets / immunology
  • Citrates
  • Citric Acid
  • Deamino Arginine Vasopressin / adverse effects*
  • Deamino Arginine Vasopressin / pharmacology
  • Edetic Acid
  • Humans
  • Macromolecular Substances
  • Male
  • Platelet Aggregation / drug effects*
  • Thrombocytopenia / chemically induced*
  • von Willebrand Diseases / blood*
  • von Willebrand Factor / metabolism


  • Antibodies, Monoclonal
  • Anticoagulants
  • Citrates
  • Macromolecular Substances
  • von Willebrand Factor
  • Citric Acid
  • Edetic Acid
  • Deamino Arginine Vasopressin