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Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Case report

Levonorgestrel-releasing intrauterine system for treatment of heavy menstrual bleeding in adolescents with Glanzmann’s Thrombasthenia: illustrated case series

Authors: Meiqiu Lu, Xin Yang

Published in: BMC Women's Health | Issue 1/2018

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Abstract

Background

Glanzmann’s Thrombasthenia (GT) is an inherited genetic disorder caused by defects in the platelet membrane glycoproteins IIb/IIIA, and is associated with heavy menstrual bleeding (HMB). HMB is a common complication in female patients, and many adolescent girls with this disease have issues with HMB beginning at menarche. The available treatment modalities including anti-fibrinolytics, nonsteroidal anti-inflammatory drugs (NSAIDs) and hormonal therapies though are effective, their associated side effects, limited efficacy and the poor compliance is a challenge in management of HMB. Levonorgestrel-releasing intrauterine system (LNG-IUS) has been a potential alternative to overcome this challenge. The use of the LNG-IUS for the management of HMB in adolescents with GT is explored in this case series.

Case presentation

Two adolescents diagnosed with GT and received the LNG-IUS as treatment modality for management of HMB is discussed in this case series.

Conclusions

For patients with poor compliance to oral hormonal therapies, the use of LNG-IUS is associated with a significant reduction of menstrual blood loss along with improved quality of life. These findings support the use of LNG-IUS to control adolescent GT-related HMB.
Literature
2.
go back to reference Solh T, Botsford A, Solh M. Glanzmann’s thrombasthenia: pathogenesis, diagnosis, and current and emerging treatment options. J Blood Med. 2015;6:219–27.CrossRefPubMedPubMedCentral Solh T, Botsford A, Solh M. Glanzmann’s thrombasthenia: pathogenesis, diagnosis, and current and emerging treatment options. J Blood Med. 2015;6:219–27.CrossRefPubMedPubMedCentral
3.
go back to reference Haghighi A, Borhany M, Ghazi A, Edwards N, Tabaksert A, Haghighi A, et al. Glanzmann thrombasthenia in Pakistan: molecular analysis and identification of novel mutations. Clin Genet. 2016;89:187–92.CrossRefPubMed Haghighi A, Borhany M, Ghazi A, Edwards N, Tabaksert A, Haghighi A, et al. Glanzmann thrombasthenia in Pakistan: molecular analysis and identification of novel mutations. Clin Genet. 2016;89:187–92.CrossRefPubMed
4.
go back to reference Nurden AT, Fiore M, Nurden P, Pillois X. Glanzmann thrombasthenia: a review of ITGA2B and ITGB3 defects with emphasis on variants, phenotypic variability, and mouse models. Blood. 2011;118:5996–6005.CrossRefPubMed Nurden AT, Fiore M, Nurden P, Pillois X. Glanzmann thrombasthenia: a review of ITGA2B and ITGB3 defects with emphasis on variants, phenotypic variability, and mouse models. Blood. 2011;118:5996–6005.CrossRefPubMed
5.
go back to reference Rosas RR, Kurth MH, Sidman J. Treatment and outcomes for epistaxis in children with Glanzmann’s thrombasthenia. Laryngoscope. 2010;120:2374–7.CrossRefPubMed Rosas RR, Kurth MH, Sidman J. Treatment and outcomes for epistaxis in children with Glanzmann’s thrombasthenia. Laryngoscope. 2010;120:2374–7.CrossRefPubMed
6.
go back to reference Chi C, Pollard D, Tuddenham EGD, Kadir RA. Menorrhagia in adolescents with inherited bleeding disorders. J Pediatr Adolesc Gynecol. 2010;23:215–22.CrossRefPubMed Chi C, Pollard D, Tuddenham EGD, Kadir RA. Menorrhagia in adolescents with inherited bleeding disorders. J Pediatr Adolesc Gynecol. 2010;23:215–22.CrossRefPubMed
7.
go back to reference Vo KT, Grooms L, Klima J, Holland-Hall C, O’Brien SH. Menstrual bleeding patterns and prevalence of bleeding disorders in a multidisciplinary adolescent haematology clinic. Haemoph Off J World Fed Hemoph. 2013;19:71–5.CrossRef Vo KT, Grooms L, Klima J, Holland-Hall C, O’Brien SH. Menstrual bleeding patterns and prevalence of bleeding disorders in a multidisciplinary adolescent haematology clinic. Haemoph Off J World Fed Hemoph. 2013;19:71–5.CrossRef
8.
go back to reference Maybin JA, Critchley HO. Medical management of heavy menstrual bleeding. Womens Health (Lond). 2016;12(1):27–34.CrossRef Maybin JA, Critchley HO. Medical management of heavy menstrual bleeding. Womens Health (Lond). 2016;12(1):27–34.CrossRef
9.
go back to reference James AH, Kouides PA, Abdul-Kadir R, Dietrich JE, Edlund M, Federici AB, et al. Evaluation and management of acute menorrhagia in women with and without underlying bleeding disorders: consensus from an international expert panel. Eur J Obstet Gynecol Reprod Biol. 2011;158:124–34.CrossRefPubMed James AH, Kouides PA, Abdul-Kadir R, Dietrich JE, Edlund M, Federici AB, et al. Evaluation and management of acute menorrhagia in women with and without underlying bleeding disorders: consensus from an international expert panel. Eur J Obstet Gynecol Reprod Biol. 2011;158:124–34.CrossRefPubMed
10.
go back to reference Andersson JK, Rybo G. Levonorgestrel-releasing intrauterine device in the treatment of menorrhagia. Br J Obstet Gynaecol. 1990;97:690–4.CrossRefPubMed Andersson JK, Rybo G. Levonorgestrel-releasing intrauterine device in the treatment of menorrhagia. Br J Obstet Gynaecol. 1990;97:690–4.CrossRefPubMed
11.
go back to reference Gupta J, Kai J, Middleton L, Pattison H, Gray R, Daniels J, et al. Levonorgestrel intrauterine system versus medical therapy for menorrhagia. N Engl J Med. 2013;368:128–37.CrossRefPubMed Gupta J, Kai J, Middleton L, Pattison H, Gray R, Daniels J, et al. Levonorgestrel intrauterine system versus medical therapy for menorrhagia. N Engl J Med. 2013;368:128–37.CrossRefPubMed
12.
go back to reference Qiu J, Cheng J, Wang Q, Hua J. Levonorgestrel-releasing intrauterine system versus medical therapy for menorrhagia: a systematic review and meta-analysis. Med Sci Monit Int Med J Exp Clin Res. 2014;20:1700–13. Qiu J, Cheng J, Wang Q, Hua J. Levonorgestrel-releasing intrauterine system versus medical therapy for menorrhagia: a systematic review and meta-analysis. Med Sci Monit Int Med J Exp Clin Res. 2014;20:1700–13.
13.
go back to reference Buitrago L, Rendon A, Liang Y, Simeoni I, Negri A, ThromboGenomics Consortium, et al. αIIbβ3 variants defined by next-generation sequencing: predicting variants likely to cause Glanzmann thrombasthenia. Proc Natl Acad Sci U S A. 2015;112:E1898–907.CrossRefPubMedPubMedCentral Buitrago L, Rendon A, Liang Y, Simeoni I, Negri A, ThromboGenomics Consortium, et al. αIIbβ3 variants defined by next-generation sequencing: predicting variants likely to cause Glanzmann thrombasthenia. Proc Natl Acad Sci U S A. 2015;112:E1898–907.CrossRefPubMedPubMedCentral
14.
go back to reference Lethaby A, Farquhar C, Cooke I. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database Syst Rev. 2000:CD000249. Lethaby A, Farquhar C, Cooke I. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database Syst Rev. 2000:CD000249.
15.
go back to reference Irvine GA, Cameron IT. Medical management of dysfunctional uterine bleeding. Baillières Best Pract Res Clin Obstet Gynaecol. 1999;13:189–202.CrossRefPubMed Irvine GA, Cameron IT. Medical management of dysfunctional uterine bleeding. Baillières Best Pract Res Clin Obstet Gynaecol. 1999;13:189–202.CrossRefPubMed
16.
go back to reference Demers C, Derzko C, David M, Douglas J. Society of Obstetricians and Gynaecologists of Canada: Gynaecological and obstetric management of women with inherited bleeding disorders. Int J Gynaecol Obstet. 2006;95:75–87.CrossRefPubMed Demers C, Derzko C, David M, Douglas J. Society of Obstetricians and Gynaecologists of Canada: Gynaecological and obstetric management of women with inherited bleeding disorders. Int J Gynaecol Obstet. 2006;95:75–87.CrossRefPubMed
17.
go back to reference Haamid F, Sass AE, Dietrich JE. Heavy menstrual bleeding in adolescents. J Pediatr Adolesc Gynecol. 2017;30(3):335–40.CrossRefPubMed Haamid F, Sass AE, Dietrich JE. Heavy menstrual bleeding in adolescents. J Pediatr Adolesc Gynecol. 2017;30(3):335–40.CrossRefPubMed
18.
go back to reference Kingman CEC, Kadir RA, Lee CA, Economides DL. The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders. BJOG Int J Obstet Gynaecol. 2004;111:1425–8.CrossRef Kingman CEC, Kadir RA, Lee CA, Economides DL. The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders. BJOG Int J Obstet Gynaecol. 2004;111:1425–8.CrossRef
19.
go back to reference Chi C, Huq FY, Kadir RA. Levonorgestrel-releasing intrauterine system for the management of heavy menstrual bleeding in women with inherited bleeding disorders: long- term follow-up. Contraception. 2011 Mar;83:242–7.CrossRefPubMed Chi C, Huq FY, Kadir RA. Levonorgestrel-releasing intrauterine system for the management of heavy menstrual bleeding in women with inherited bleeding disorders: long- term follow-up. Contraception. 2011 Mar;83:242–7.CrossRefPubMed
20.
go back to reference Lee BS, Ling X, Asif S, Kraemer P, Hanisch JU, Inki P. Levonorgestrel-releasing intrauterine system versus conventional medical therapy for heavy menstrual bleeding in the Asia-Pacific region. Int J Gynaecol Obstet. 2013;121:24–30.CrossRefPubMed Lee BS, Ling X, Asif S, Kraemer P, Hanisch JU, Inki P. Levonorgestrel-releasing intrauterine system versus conventional medical therapy for heavy menstrual bleeding in the Asia-Pacific region. Int J Gynaecol Obstet. 2013;121:24–30.CrossRefPubMed
Metadata
Title
Levonorgestrel-releasing intrauterine system for treatment of heavy menstrual bleeding in adolescents with Glanzmann’s Thrombasthenia: illustrated case series
Authors
Meiqiu Lu
Xin Yang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0533-0

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