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一例罕见的伴发因子 VII 缺乏的 glanzmann 血小板无力症。

A rare case of glanzmann thrombasthenia with concomitant factor VII deficiency.

机构信息

Department of Medicine and Surgery (MBBS), Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

Department of Medicine, Dr. Ruth K.M. Pfau Civil Hospital & Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Ann Hematol. 2024 Nov;103(11):4779-4781. doi: 10.1007/s00277-024-05947-x. Epub 2024 Aug 25.

DOI:10.1007/s00277-024-05947-x
PMID:39182199
Abstract

Glanzmann thrombasthenia and clotting factor VII deficiency are rare autosomal recessive bleeding disorders. But the occurrence of both in the same person is an extremely rare phenomenon. Here, we present the case of a young female from Sindh, Pakistan that got diagnosed with Glanzmann thrombasthenia and concomitant moderate factor VII deficiency, a combination not previously reported in the country. The patient exhibited typical clinical manifestations including menorrhagia, nasal bleeds, and prolonged bleeding after minor injuries, compounded by a positive family history and consanguinity. Laboratory investigations revealed marked anemia, prolonged bleeding time, and abnormal platelet aggregation studies consistent with Glanzmann thrombasthenia. The identification of this rare combination relied on comprehensive clinical evaluation, emphasizing the importance of family history in suspected cases. Management involved platelet transfusions, tranexamic acid, and Factor VII replacement, resulting in clinical improvement.

摘要

血小板无力症和凝血因子 VII 缺乏症是罕见的常染色体隐性遗传性出血性疾病。但两者同时发生在同一个人身上是极为罕见的现象。在这里,我们介绍了一位来自巴基斯坦信德省的年轻女性病例,她被诊断为血小板无力症和伴发中度因子 VII 缺乏症,这种组合在该国以前没有报道过。该患者表现出典型的临床表现,包括月经过多、鼻出血和轻微损伤后长时间出血,并伴有阳性家族史和近亲结婚。实验室检查显示明显贫血、出血时间延长和血小板聚集研究异常,符合血小板无力症的特征。这种罕见组合的确定依赖于全面的临床评估,强调了在疑似病例中家族史的重要性。治疗包括血小板输注、氨甲环酸和因子 VII 替代治疗,从而改善了临床症状。

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本文引用的文献

1
Factor VII deficiency: a rare genetic bleeding disorder in a 7-year-old child: a case report.因子 VII 缺乏症:7 岁儿童中罕见的遗传性出血性疾病:病例报告。
J Med Case Rep. 2023 Apr 14;17(1):138. doi: 10.1186/s13256-023-03884-3.
2
Glanzmann Thrombasthenia in Pakistani Patients: Identification of 7 Novel Pathogenic Variants in the Fibrinogen Receptor αIIbβ3.巴基斯坦患者的 Glanzmann 血小板无力症:纤维蛋白原受体 αIIbβ3 中的 7 种新型致病性变异的鉴定。
Cells. 2023 Jan 4;12(2):213. doi: 10.3390/cells12020213.
3
Description and Clinical Management of Patients With Glanzmann's Thrombasthenia in a University Hospital, a Referral Center Specialized in Hemostasis, in Bogotá, Colombia.
哥伦比亚波哥大一家大学医院(一家专门从事止血的转诊中心)中Glanzmann血小板无力症患者的描述与临床管理
Cureus. 2022 Jun 4;14(6):e25657. doi: 10.7759/cureus.25657. eCollection 2022 Jun.