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Clinical and laboratory characteristics of adolescents with platelet function disorders and heavy menstrual bleeding

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Author(s): Amesse Lawrence S | Pfaff-Amesse Teresa | Gunning William T | Duffy Nancy | French James A

Journal: Experimental Hematology & Oncology
ISSN 2162-3619

Volume: 2;
Issue: 1;
Start page: 3;
Date: 2013;
Original page

Keywords: Platelet function disorders | Adolescents | Heavy menstrual bleeding | Menorrhagia | δ-Storage Pool Deficiency (δ-SPD)

ABSTRACT
Abstract Background Platelet function disorders (PFDs) have emerged as an important etiology of heavy menstrual bleeding (HMB) in adolescents. However, neither clinical nor laboratory data have been methodically analyzed in this population subset. The objective of this study was to evaluate these parameters in order to distinguish characteristics of the disorder that in turn will lead to earlier diagnosis and therapy initiation. Methods Retrospective review of medical records from postmenarcheal adolescents with documented PFDs referred to a hemophilia treatment center and university faculty practices for bleeding diatheses with their clinical and laboratory data evaluated. Results Of 63 teens with documented PFDs, HMB was the most common clinical manifestation of PFD (43; 68.3%). Of these, 37 (86%) were diagnosed with PFD either at or after menarche with the diagnosis based on HMB symptoms alone. Only 6 (14%) were diagnosed with a PFD prior to menarche, based on associated bleeding, i.e., epistaxis, ecchymosis, and all developed HMB after menstruation onset. Interestingly, 20 girls were diagnosed with a PFD prior to menarche and of these, only 6 (30%) went on to develop HMB after pubertal transition, while the majority (14; 70%) did not. The average age-at-PFD diagnosis was 14.5yrs, significantly differing from the 10.9yrs average age-at-PFD diagnosis in their counterparts that, after menarche, did not develop HMB (P
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