Low dose danazol is effective in management of erythropoietin induced thrombosis

A.K. Al-Momen, Sameer Huraib, A. M. A. Gader, Fathia Sulaimani
In: Thrombosis Research · 1991 · vol. 64(5) , pp. 527–532 · doi:10.1016/s0049-3848(05)80001-5 · PMID:1808758 · W1998168552
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This study investigated the effectiveness of low-dose danazol in managing thrombosis caused by erythropoietin.

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Abstract

Two patients (one male and one female) with end stage renal disease on chronic hemodialysis were treated with recombinant human erythropoietin (r-HuEPO). Both patients developed significant clotting in the vascular access and extracorporeal circuits. Coagulation studies indicated that both patients acquired high levels of tissue-type plasminogen activator inhibitor (PAI) with deficiency in tissue-type plasminogen activator (t-PA) and consequent impaired fibrinolysis. Their fibrinolytic activity was normalized with danazol therapy in doses as low as 2-4 mg/kg given orally once daily. We conclude that r-HuEPO-induced thrombosis is associated with impaired fibrinolysis due to acquired elevation of PAI which can be effectively prevented by small doses of danazol.

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