title: Glanzmann's Thrombasthenia Diagnosed following Knee Arthroscopy.
abstract: A 41-year-old man with an unremarkable medical history presented with a painful knee after a sports injury. He was diagnosed with a medial meniscal tear. Symptoms did not abate after 6 months of physical therapy, and he underwent arthroscopic partial medial meniscectomy. A week after beginning physical therapy he experienced a knee effusion, decreased ROM, and inability to flex his quadriceps. His knee was aspirated. Blood tests were ordered and his complete blood count, liver functions tests, and INR/PTT were normal. The patient had recurrent effusions requiring three additional joint aspirations. Ten weeks after the initial surgery, the patient underwent a second arthroscopy, during which a hematoma was removed and a synovectomy performed. The patient continued bleeding from the incisions after portals were sutured, and he was admitted to the hospital. A hematologist was consulted and comprehensive platelet aggregation testing revealed previously undiagnosed Glanzmann's thrombasthenia. The patient began treatment with platelet infusions and desmopressin and progressed to a full recovery. Clinical suspicion for surgical patients with unusual repetitive postoperative bleeding should include previously undetected rare bleeding disorders even in adults.
authors.affiliation: UHZ Sports Medicine Institute, Doctors Hospital, Baptist Health South Florida, 1150 Campo Sano Avenue, Suite 200, Coral Gables, FL 33146, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Zvijac
authors.affiliation: UM Sylvester Cancer Center at Kendall, 8932 SW 97 Avenue, Suite B12, Miami, FL 33176, USA.
authors.forename: Sharhabil S
authors.initials: SS
authors.lastname: Ammus
authors.affiliation: FIU Herbert Wertheim College of Medicine, Miami, FL 33199, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Aran
authors.affiliation: Center for Research and Grants, Doctors Hospital, Baptist Health South Florida, 1150 Campo Sano Avenue, Suite 200, Coral Gables, FL 33146, USA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Kiebzak