The use of desmopressin in children with coagulation disorders.

Hemophilia A, von Willebrand's disease and uremia prolong the bleeding time in affected children. Management of hemorrhage is difficult in these patients, and often requires multiple therapeutic modalities. Desmopressin, a synthetic analog of arginine vasopressin (DDAVP), decreases the bleeding time in patients with these disorders. We describe a case of a child with uremia and spontaneous epistaxis originating from the adenoid. Bleeding was controlled with administration of DDAVP and other measures. DDAVP is effective for the rapid, temporary correction of prolonged bleeding time associated with hemophilia A, von Willebrand's disease or uremia. The use of DDAVP avoids the risks associated with blood component transfusion. DDAVP may be used as a single hemostatic agent in minor surgical procedures, or in combination with other therapeutic modalities in major surgical procedures.