Effect of danazol on coagulation parameters and bleeding in hemophilia
H. S. Garewal, J. J. Corrigan Jr, B. G. Durie, M. A. Jeter and M. L. Damiano
Danazol was given orally at a dose of 600 mg/day to six hemophiliacs for
eight to 14 weeks. All patients showed a significant decrease in activated
partial thromboplastin time (APTT) beginning with the first measurement
(two weeks) and persisting until use of the drug was discontinued. However,
a corresponding increase in the deficient factor activity could not be
consistently demonstrated. Despite the shortened APTT, bleeding episodes
continued in the severe hemophiliacs and the patient with Christmas
disease. In four patients, bleeding appeared to increase in severity or
change in pattern, and in two cases the bleeding manifestations did not
respond to usual factor infusions but responded to discontinuation of the
drug therapy and further factor replacement. Euglobulin lysis times were
measured in five patients (one hemophiliac and four with nonhemophilic
conditions) who were receiving danazol. The lysis times were markedly
shortened. Increased fibrinolytic activity may be responsible for the
increased bleeding manifestations in danazol-treated hemophiliacs.