[Intravenous administration of deamino-D-arginine-vasopressin (DDAVP) to patients with hemophilia A and von Willebrand's disease]. / Stosowanie dozylne dezamino-D-arginino-wazopresyny (DDAVP) u chorych na hemofilie A i w chorobie von Willebranda.

Following an intravenous infusion of DDAVP in a single dose of 0.3 microgram/kg b.w. and subsequent infusion of 4 g of epsilon-aminocaproic acid, 28 tooth extractions have been performed in 18 patients with mild haemophilia A and 5 patients with type I von Willebrand's disease. During the subsequent 7-10 days, the patients received epsilon-aminocaproic acid orally. In 89% of cases the healing was uneventful and no bleeding complications occurred. A single infusion of DDAVP and epsilon-aminocaproic acid was also effective for the management of muscle hematoma ++ and haemarthroses in 4 of the 7 mildly affected haemophiliacs. In the remaining 3, the symptoms of bleeding subsided following repeated infusion of DDAVP. The results indicate that a single intravenous infusions of DDAVP when combined with the administration of antifibrinolytic agents can insure sufficient haemostasis after tooth extraction and is useful for the management of muscle hematoma and hemarthroses in patients with mild haemophilia A mild von Willebrand's disease.

[Serological markers of hepatitis B virus and cytomegalovirus in patients with hemophilia]. / Serologiczne znaczniki wirusa zapalenia watroby typu B i wirusa cytomegalii u chorych na hemofilie.

In 100 adult patients with severe haemophilia A (78 patients) and B (22 patients) sera were screened for the presence of serological markers of hepatitis B virus (HBV) and of cytomegalovirus (CMV) and liver function tests were performed which included measurement of serum aminotransferase AST and ALT activities, total bilirubin concentration and plasma levels of factor VII and X. In all the patients at least one out of five determined HBV markers (HBsAg. HBeAg, anti-HBs, anti-HBc and anti-HBe) was detected. HBsAg was found in 10% of the patients, and its prevalence in haemophiliacs B was higher than than observed in haemophiliacs A (22.7% and 6.4%, respectively). HBsAg appeared more frequently in patients receiving factor VIII concentrates (16.7%) than in those treated with cryoprecipitate (4.5%). Anti-CMV antibody was detected in sera of 98% of the patients. In 1/3 samples of cryoprecipitate anti-HBc or anti-HBs were present, and in the half of samples anti-CMV occurred. Abnormal liver function tests indicating chronic hepatitis or liver cirrhosis were obtained in 8 patients. Raised ALT activity which could suggest chronic infection with non-A, non-B virus occurred in 6 cases. The present study indicates that haemophiliacs frequently transfused with plasma products are at high risk for viral infections leading to liver dysfunction.