Hossain Nazli, Shamsi Tahir S, Feroz Adeel
Department of Obstetrics & Gynecology Unit 3, Dow University of Health Sciences, Baba-e-Urdu Road, Karachi 74200, Pakistan.
Case Rep Hematol. 2012;2012:530908. doi: 10.1155/2012/530908. Epub 2012 Mar 20.
Glanzmann's thromboasthenia (GT) is a rare platelet disorder, due to membrane defects involving glycoprotein GP IIb/IIIa complex. Symptoms appear in infancy with episodes of bruising, gingival bleeding, epistaxis, or at the time of menarche acute episode of uterine bleeding. Hormonal therapy and antifibrinolytic agents are first-line treatment. Platelet transfusion is given to control hemorrhage when medical treatment fails. However, repeated transfusions may result in development of platelet refractioness, due to development of antibodies against membrane glycoprotein. Activated recombinant FVII is licensed for use in acute control of bleeding in GT. Here we report a case of acute juvenile uterine bleeding at menarche, which responded successfully to uterine tamponade. To our knowledge, this is the first case report on use of balloon tamponade for control of acute catastrophic juvenile bleeding at menarche.
Glanzmann血小板无力症(GT)是一种罕见的血小板疾病,由涉及糖蛋白GP IIb/IIIa复合物的膜缺陷引起。症状在婴儿期出现,表现为瘀伤、牙龈出血、鼻出血,或在初潮时出现子宫急性出血。激素治疗和抗纤维蛋白溶解剂是一线治疗方法。当药物治疗无效时,给予血小板输注以控制出血。然而,由于针对膜糖蛋白的抗体产生,反复输血可能导致血小板输注无效。活化重组FVII已获许可用于GT出血的急性控制。在此,我们报告一例初潮时急性青少年子宫出血病例,该病例成功通过子宫压迫止血。据我们所知,这是首例关于使用球囊压迫控制初潮时急性灾难性青少年出血的病例报告。