Tx for mild hemophilia?

• A. Vitamin K
• B. FFP
• C. Factor VIII or IX
• D. Desmopressin

Answer: (D)

Desmopressin works by triggering release of stored factor VIII and von Willebrand factor from the endothelium, raising their circulating levels quickly. In many people with mild factor VIII deficiency, this produces a substantial increase in FVIII activity, improving clot formation for minor bleeds or procedures without needing factor concentrates. It’s especially useful in mild hemophilia A and in von Willebrand disease, where this release mechanism boosts both FVIII and vWF. It does not address factor IX deficiency, so it isn’t effective for mild hemophilia B. Vitamin K isn’t helpful for FVIII/IX deficiencies, and fresh frozen plasma is a broader, less targeted option with more risks. Desmopressin is therefore the preferred initial therapy when a patient with mild hemophilia is likely to respond.