title: Evaluation of the Hemostatic Disorders in Adolescent Girls with Menorrhagia: Experiences from a Tertiary Referral Hospital.
abstract: Bleeding disorders are a common cause of menorrhagia in the adolescent age group. We aimed to evaluate the incidence of hemostatic disorders, using clinical and laboratory findings of bleeding disorders in adolescent girls with menorrhagia. A retrospective chart review used to evaluate adolescent girls with menorrhagia who were referred to Yuzuncu Yil University Pediatric Hematology clinic between January 2010 and December 2014. Out of 52 patients referred for investigation, 50 patients were included in the study. The mean age and mean menarche age were 14.8 ± 1.42 (range: 12-17) and 12.47 ± 0.55, respectively. In 42 % (n = 21) of patients, anemia was detected. In 22 % (n = 11) of patients, a bleeding disorder was detected: five cases with von Willebrand disease, two cases with acute immune thrombocytopenic purpura, one case with Bernard-Soulier syndrome, one case with Glanzmann thrombasthenia, one case with aplastic anemia and one case with factor X deficiency. The remaining 39 out of the 50 patients were finally diagnosed with dysfunctional uterine bleeding. When compared the patients with bleeding disorders and without bleeding disorders, bleeding from other sites, including gingival bleeding or epistaxis, low platelet counts and prolonged activated partial thromboplastin time were found statistically more frequent in patients with bleeding disorders (p < 0.05). Menorrhagia in adolescents is frequently associated with underlying bleeding disorders. Adolescents with heavy menstrual bleeding and a history of nose or gingival bleeding should be evaluated for congenital bleeding disorders.
authors.affiliation: Department of Pediatric Hematology, Yuzuncu Yil University, 65100 Van, Turkey.
authors.forename: Kamuran
authors.initials: K
authors.lastname: Karaman
authors.affiliation: Department of Pediatrics, Yuzuncu Yil University, Van, Turkey.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Ceylan
authors.affiliation: Department of Obstetric and Gynecology, Yuzuncu Yil University, Van, Turkey.
authors.forename: Erbil
authors.initials: E
authors.lastname: Karaman
authors.affiliation: Department of Pediatric Hematology, Yuzuncu Yil University, 65100 Van, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Akbayram
authors.affiliation: Department of Family Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Hatice Tuba
authors.initials: HT
authors.lastname: Akbayram
authors.affiliation: Department of Pediatric Endocrinology, Yuzuncu Yıl University, Van, Turkey.
authors.forename: Sultan
authors.initials: S
authors.lastname: Kaba
authors.affiliation: Department of Pediatric Hematology, Yuzuncu Yil University, 65100 Van, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Garipardıç
authors.affiliation: Department of Pediatric Hematology, Yuzuncu Yil University, 65100 Van, Turkey.
authors.forename: Ahmet Fayik
authors.initials: AF
authors.lastname: Öner
keywords: Adolescent gynecology; Anemia; Bleeding disorders; Menorrhagia; von Willebrand disease