Heavy Menstrual Bleeding as a Common Presenting Symptom of Rare Platelet Disorders: Illustrative Case Examples

Madhvi Rajpurkar, Sarah H. O'Brien, Fareeda W. Haamid, David L. Cooper, Sriya Gunawardena, Meera Chitlur

Research output: Contribution to journalShort surveypeer-review

13 Scopus citations

Abstract

Heavy menstrual bleeding (HMB) is a common symptom in patients who present to the obstetrician-gynecologist or adolescent medicine specialist and might result from an underlying inherited bleeding disorder. Whereas relatively common bleeding disorders such as von Willebrand disease are often included in standard laboratory assessments, rarer platelet function disorders can be challenging to diagnose. Additionally, HMB can be a particularly difficult symptom to manage in adolescents with platelet function disorders, and it is associated with decreased quality of life. We review the diagnostic and management issues of patients with platelet function disorders through the presentation of 2 patient case reports, with a focus on a diagnosis of Glanzmann thrombasthenia, an inherited qualitative disorder that affects platelet function. Whereas the first patient presented to the emergency department before the diagnosis of a bleeding disorder and required a hematologic referral and extensive laboratory assessments, the second patient had been diagnosed with Glanzmann thrombasthenia as a child but experienced severe management challenges at the onset of menarche. In both patients, collaboration between the obstetrician-gynecologist or adolescent medicine specialist and the hematologist was critical for achieving acute management of the bleeding symptoms and for ensuring optimal long-term disease management. Together, these cases highlight the importance of properly identifying females with HMB who might have an undiagnosed bleeding disorder and of consulting with a hematologist to determine an appropriate management plan throughout all life stages.

Original languageEnglish
Pages (from-to)537-541
Number of pages5
JournalJournal of Pediatric and Adolescent Gynecology
Volume29
Issue number6
DOIs
StatePublished - Dec 1 2016

Keywords

  • Blood coagulation disorders
  • Glanzmann thrombasthenia
  • Menorrhagia
  • Platelet aggregation
  • Platelet function disorder

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