title: Severe menorrhagia due to factor VII deficiency successfully treated by thermal balloon endometrial ablation.
abstract: Factor VII deficiency, a rare inherited bleeding disorder, is often complicated by menorrhagia leading to severe anemia. These women are treated by repeated blood product transfusions, various hormone preparations, and repeated endometrial curettage. Despite the high risks involved, women with refractory disease were usually advised to undergo hysterectomy. A 36-year-old patient was known to suffer from factor VII deficiency and common variable immune deficiency, and had a long history of worsening menorrhagia. As various medical therapies failed to improve her menorrhagia, and she often required curettage and blood transfusions, we offered her more definitive treatment with thermal balloon endometrial ablation. The procedure was uneventful, and during 24 months of follow-up the patient has had several events of spotting but no heavy periods. It is suggested that thermal balloon endometrial ablation is a suitable minimally invasive therapeutic option for menorrhagia in women with factor VII deficiency.
authors.affiliation: Department of Obstetrics and Gynaecology, Hebrew University, Hadassah Medical Centre, Kiryat Hadassah, POB 12000, IL-91120, Jerusalem.
authors.forename: Sozos J
authors.initials: SJ
authors.lastname: Fasouliotis
authors.forename: Asher
authors.initials: A
authors.lastname: Shushan
mesh_terms: D000328:Adult; D021721:Balloon Occlusion / Q000379:methods; D017115:Catheter Ablation / Q000379:methods*; D005168:Factor VII Deficiency / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000379:methods; D008595:Menorrhagia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome