Wang Yiran, Zhao Lanbo, Feng Xue, Li Qing, Ma Sijia, Liang Dongxin, Liu Mingge, Yin Panyue, Li Qiling, Lu Qinrui
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Guipei 77, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
Front Med (Lausanne). 2020 May 21;7:181. doi: 10.3389/fmed.2020.00181. eCollection 2020.
If a woman suffers from congenital fibrinogen deficiency (CFD), she might undergo hypermenorrhea monthly and possibly to suffer from hemoperitoneum due to a ruptured follicle or corpus luteal cyst every month, which seriously threaten her health and quality of life. Here, we creatively used a combination of the levonorgestrel-releasing intrauterine system (LNG-IUS) and the combined oral contraceptives (COC) for a girl with CFD. A 14-year-old girl presented with no obvious cause of persistent and severe lower abdominal pain that began 8 h prior. After examination, she was diagnosed as hemoperitoneum. CFD was diagnosed when she was 2 years old and she had two hospitalizations due to hemorrhagic anemia caused by menorrhagia. Therefore, after successful conservative treatment of hemoperitoneum, a combination of LNG-IUS and COC was used for the long-term conservative management of hypermenorrhea and hemoperitoneum. During the half-year of follow-up, she had hypomenorrhea without hemoperitoneum. To the best of our knowledge, this was the first patient treated with such a procedure in the literature, and we recommend every woman with CFD at puberty or reproductive age receives this two-pronged treatment.
如果一名女性患有先天性纤维蛋白原缺乏症（CFD），她可能每月都会出现月经过多的情况，并且可能由于每月卵泡破裂或黄体囊肿而发生腹腔积血，这严重威胁到她的健康和生活质量。在此，我们创新性地对一名患有CFD的女孩联合使用了左炔诺孕酮宫内节育系统（LNG-IUS）和复方口服避孕药（COC）。一名14岁女孩出现持续且严重的下腹痛，无明显诱因，疼痛始于8小时前。经检查，她被诊断为腹腔积血。她2岁时被诊断出患有CFD，曾因月经过多导致出血性贫血住院两次。因此，在成功保守治疗腹腔积血后，联合使用LNG-IUS和COC对月经过多和腹腔积血进行长期保守治疗。在半年的随访期间，她月经量减少且未发生腹腔积血。据我们所知，这是文献中首例接受这种治疗方法的患者，我们建议青春期或育龄期患有CFD的每位女性都接受这种双管齐下的治疗。
