Gu Zhi-Chun, Shi Fang-Hong, Zhu Jie, Wan Fang, Shen Long, Li Hao
Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Pharmacol. 2019 Jan 15;9:1573. doi: 10.3389/fphar.2018.01573. eCollection 2018.
Heavy menstrual bleeding (HMB), previously known as menorrhagia, is in place with heavy flow and longer lasting days of bleeding during menstrual period, sequentially leading to anemia. We reported a rare case of HMB in a 33-year-old patient after percutaneous coronary intervention (PCI), who presented with acute coronary syndromes (ACS), uremia and systemic lupus erythematosus before PCI. This patient received three times of hemodialysis weekly (Monday, Wednesday, and Friday). On the next day after PCI, this patient began to have menstruation. On the fifth day of menstruation, the patient complained of HMB and physical discomfort, with an urgent need for consultation of gynecologist. After gynecologist consultation, this patient was under oxytocin treatment. However, 2 days of oxytocin treatment did not significantly improve HMB. Afterward, the menstrual volume of patients was significantly reduced on eighth day of menstruation after once therapy of testosterone propionate and norethindrone. Regarding the reasons of HMB, heparin in hemodialysis and antiplatelet drugs utilized (aspirin and clopidogrel) after PCI may be contributors to the HMB. In addition, uterine myoma, cervical canal cyst, renal insufficiency and heterozygous are also possible contributors to HMB. There is no such case of whom had HMB in reproductive age with ACS, uremia and systemic lupus erythematosus under hemodialysis and antiplatelet therapy. More clinical safety data on HMB of reproductive age women who are under antithrombotic therapy are required.
月经过多（HMB），以前称为月经过多，表现为月经量多且经期持续时间延长，继而导致贫血。我们报告了一例罕见的33岁经皮冠状动脉介入治疗（PCI）后出现HMB的患者，该患者在PCI前患有急性冠状动脉综合征（ACS）、尿毒症和系统性红斑狼疮。该患者每周接受三次血液透析（周一、周三和周五）。PCI后的第二天，该患者开始月经来潮。月经第五天，患者主诉月经过多及身体不适，急需咨询妇科医生。经妇科医生会诊后，该患者接受了催产素治疗。然而，催产素治疗2天并未显著改善月经过多的情况。随后，在丙酸睾酮和炔诺酮治疗一次后，患者月经第八天月经量显著减少。关于月经过多的原因，血液透析中的肝素以及PCI后使用的抗血小板药物（阿司匹林和氯吡格雷）可能是导致月经过多的原因。此外，子宫肌瘤、宫颈管囊肿、肾功能不全和杂合性也可能是月经过多的原因。在接受血液透析和抗血小板治疗的育龄期患有ACS、尿毒症和系统性红斑狼疮的患者中，尚无月经过多的此类病例。需要更多关于接受抗血栓治疗的育龄期女性月经过多的临床安全性数据。
