Management of refractory menstrual bleeding in an adolescent with glanzmann thrombasthenia: a case report and review
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Authors
King, Luke J.
Huff, Jessie
Heber, Deidre
Miller, Michal Ann
Marshall, Brytanie
Issue Date
2020-09-30
Type
Other
Language
en_US
Keywords
Refractory Menstrual Bleeding , Glanzmann Thrombasthenia
Alternative Title
Abstract
Glanzmann Thrombasthenia is a rare bleeding disorder causing life-threatening bleeding at menarche in the adolescent female. Bleeding often necessitates admission and multiple blood transfusions. Due to the rarity of the disease, management of acute bleeding in new-onset menarche poses a particular challenge. A 12-year-old menarchial female had persistent vaginal bleeding despite multiple treatment modalities including aminocaproic acid, recombinant factor VIIa, intravenous estrogen, and gonadotropin receptor hormone agonists. Although the standard treatment of bleeding in patients with GT is primarily rFVIIa, new-onset menstrual bleeding in conjunction with an immature hypothalamic-pituitary-ovarian axis often requires expanding treatment to include multiple drug modalities. In our case, a two-step approach was necessary. The first is targeting the cessation of the first menses. The second is optimizing ongoing management of long-term control of heavy menstrual bleeding to achieve amenorrhea, prevent further hospital admissions, and avoid recurrent transfusions.
Description
Citation
King, L. J., Huff, J., Heber, D., Miller, M. A., & Marshall, B. (2020). Management of Refractory Menstrual Bleeding in an Adolescent with Glanzmann Thrombasthenia: A Case Report and Review. Case reports in obstetrics and gynecology, 2020, 8848763. https://doi.org/10.1155/2020/8848763
Publisher
Case Reports in Obstetrics and Gynecology