Boeckelmann Doris, von Dobeneck Lara, Henkes Hans, Eichler Hermann, Glonnegger Hannah, Zieger Barbara
Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center-University of Freiburg, 79106 Freiburg, Germany.
Neuroradiological Clinic, Klinikum Stuttgart, 70174 Stuttgart, Germany.
Diseases. 2024 Jun 27;12(7):136. doi: 10.3390/diseases12070136.
Glanzmann Thrombasthenia (GT) is an inherited platelet disorder caused by defects in platelet integrin αβ (GPIIb/IIIa), which is a platelet receptor essential for the binding of fibrinogen. This can lead to severe bleeding, especially after trauma or perioperatively, and to microcytic anemia because of chronic blood loss. We report on a 40-year-old female patient with extensive bleeding complications and platelet antibody formation who presented in Homburg and Freiburg for extensive platelet function analyses and molecular genetic analyses. According to platelet aggregometry, the patient had previously been diagnosed with Glanzmann Thrombasthenia (GT). In addition, an MRI scan had been performed due to an unsteady gait and had revealed bilateral para-ophthalmic aneurysms of both internal carotid arteries (ICAs). Assuming a 5% rupture risk per 5 years for each aneurysm, the patient was offered and accepted endovascular treatment. Next-generation sequencing (NGS) panel analysis identified a previously undescribed homozygous one-base-pair deletion in , which leads to a loss of function of the α-subunit of the receptor. This case illustrates the difficulties that can arise regarding the treatment of patients with rare platelet bleeding disorders, and supports the importance of continuous medical care by a specialized hemophilia center for these patients.
血小板无力症(GT)是一种遗传性血小板疾病,由血小板整合素αβ(糖蛋白IIb/IIIa)缺陷引起,糖蛋白IIb/IIIa是纤维蛋白原结合所必需的血小板受体。这可能导致严重出血,尤其是在创伤后或围手术期,以及由于慢性失血导致的小细胞贫血。我们报告了一名40岁女性患者,她有广泛的出血并发症和血小板抗体形成,在洪堡和弗莱堡接受了广泛的血小板功能分析和分子遗传学分析。根据血小板聚集试验,该患者此前被诊断为血小板无力症(GT)。此外,由于步态不稳进行了MRI扫描,结果显示双侧颈内动脉(ICA)眼旁动脉瘤。假设每个动脉瘤每5年破裂风险为5%,该患者接受并接受了血管内治疗。下一代测序(NGS)面板分析在 中发现了一个先前未描述的纯合单碱基对缺失,这导致受体α亚基功能丧失。该病例说明了罕见血小板出血性疾病患者治疗中可能出现的困难,并支持了专业血友病中心对这些患者持续医疗护理的重要性。