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Coagulation Disorders in Women with Idiopathic Menorrhagia

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Author(s): Mehran Karimi | Abdolreza Afrasiabi | Sedighe Amoei | Jale Zolghadri | Shiva Nasirabadi | Mohammadreza Bordbar | Flora Peyvndi

Journal: The Asia-Pacific Journal of Oncology & Hematology
ISSN 1759-6637

Volume: 2;
Issue: 1;
Start page: 19;
Date: 2010;
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Keywords: coagulation disorders | idiopathic menorrhagia | women

ABSTRACT
Hemostasis of the endometrium is directly related to platelet and fibrin function. Deficiencies in either of these components result in menorrhagia in women with coagulation disorders. We studied coagulation parameters in women with idiopathic menorrhagia in southern Iran to determine the relationship between menorrhagia and coagulation disorders. The study group included 121 women seen between July 2006 and August 2008. All patients were referred by two expert gynecologists during complete workup that included filling out a pictorial chart and diagnosing idiopathic menorrhagia based on blood loss of more than 80 mL per menstrual cycle or more than 7 days of continuous bleeding. Mean age of the women was 23 years (range 15–46 years). Laboratory diagnostic tests in all women included prothrombin time, partial thromboplastin time (PTT), complete blood count, bleeding time, factor assays (factors V, VII, VIII, X, XI), von Willebrand factor (vWF) antigen, ristocetin cofactor activity, and platelet function tests. Some 19.8% (24/121) of the patients had decreased vWF activity and antigen levels, 6.6% were diagnosed with type 2 von Willebrand disease (vWD), and 13.2% with type 1 vWD. In 12 patients (9.9%), PTT was prolonged with decreased FVIII level (8.3–47.8%). Three patients (2.5%) had mild FV, FVII, or FIX deficiency. Five patients (4%) had mild FX deficiency. Two women (1.6%) had Glanzman’s thrombasthenia, and one (0.8%) had Bernard–Soulier syndrome. This study confirms that menorrhagia may be the initial symptom of rare bleeding disorders as well as vWD and platelet disorders. These coagulation disorders should be investigated in women with idiopathic menorrhagia.
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