Platelet Aggregation Induced by dDAVP in Platelet-Type von Willebrand's Disease

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To the Editor: Holmberg et al. (Oct. 6 issue) 1 report that infusion of l-desamino-8-D-arginine vasopressin (DDAVP)2 caused platelet aggregation and thrombocytopenia in patients with Type I IB von Willebrand's disease3 and that, in vitro, the platelets in normal platelet-rich plasma aggregated upon addition of plasma obtained from patients with Type IIB disease, after infusion of DDAVP. We have observed similar phenomena in patients with platelet-type (or pseudo) von Willebrand's disease,4 5 6 in which the platelet–von Willebrand factor interaction is increased as the result of an intrinsic platelet abnormality. Their platelets adsorb normal von Willebrand factor at lower concentrations of ristocetin than . . .

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