Get access

Platelet function defects in adolescents with heavy menstrual bleeding

Authors

  • H. L. Mills,

    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
    Search for more papers by this author
    • Both authors contributed equally to the study
  • M. S. Abdel-Baki,

    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
    Search for more papers by this author
    • Both authors contributed equally to the study
  • J. Teruya,

    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
    3. Division of Transfusion Medicine, Baylor College of Medicine, Houston, TX
    Search for more papers by this author
  • J. E. Dietrich,

    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, TX, USA
    Search for more papers by this author
  • M. D. Shah,

    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
    Search for more papers by this author
  • D. Mahoney Jr.,

    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
    Search for more papers by this author
  • D. L. Yee,

    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
    Search for more papers by this author
  • L. V. Srivaths

    Corresponding author
    1. Department of Pediatrics, Baylor College of Medicine, Houston, TX
    2. Section of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX
    • Correspondence: Lakshmi Venkat Srivaths, MD, Associate Professor, Department of Pediatrics, Section of Hematology/Oncology, Texas Children's Hospital / Baylor College of Medicine, 6701, Fannin Street, Houston, TX 77030, USA.

      Tel.: (832) 822-1514; fax: (832) 825-0285; e-mail: lvsrivat@txch.org

    Search for more papers by this author

Summary

Platelet function defects (PFD) are reported to occur frequently in adult women with heavy menstrual bleeding (HMB). Few studies on adolescent HMB report varying incidence rates (2–44%) for PFD. We reviewed our institutional experience in detecting and managing PFD in adolescent HMB. Postmenarchial girls and adolescents with HMB seen at our institution undergo a comprehensive bleeding disorder work-up by paediatric haematology and paediatric gynaecology providers. Whole blood platelet aggregometry (WBPA) is performed as a second tier test after excluding thrombocytopaenia, coagulation factor deficiencies and Von Willebrand disease (VWD). We retrospectively reviewed the medical records of adolescents with HMB seen between June 2009 and November 2010, as approved by the Institutional Review Board. Patient demographics, clinical features, laboratory results, therapy details and patient outcome information were analysed. Overall, 114 postmenarchial girls and adolescents with HMB were evaluated; 68 patients (59%) had WBPA study performed. Nineteen patients (28%) had at least one aggregation or secretion defect; 12 (18%) had two or more such defects. Treatment included hormonal therapy (13/19; 68%), antifibrinolytic agents (8/19; 42%) and intra-nasal DDAVP (3/19; 16%). Thirteen patients (81%) had improved outcome (median follow-up – 15.6 months; range of 1–66 months). In this study, PFD were identified in nearly one-third of girls with HMB, with the majority of these having two or more defects as identified by WBPA. Further prospective studies are needed to better define the prevalence and address appropriate management of HMB and other bleeding complications of PFD in adolescents.

Ancillary