Faculty Collaboration Database

Bleeding disorders: A common cause of menorrhagia in adolescents. J Pediatr 2001 Jun;138(6):856-61

Date

06/08/2001

Pubmed ID

11391329

DOI

10.1067/mpd.2001.113042

Scopus ID

2-s2.0-0034971466 (requires institutional sign-in at Scopus site)   154 Citations

Abstract

OBJECTIVE: To determine the frequency of underlying bleeding disorders in adolescents with menorrhagia.

STUDY DESIGN: We retrospectively reviewed the charts of all girls, aged 10 to 19 years, who presented to our children's hospital for inpatient or outpatient evaluation of menorrhagia between January 1990 and November 1998.

RESULTS: At presentation, 9 of the 71 girls (13%) had thrombocytopenia (platelet count <150,000/microL; range, 5000-106,000/microL). The most common causes for thrombocytopenia were immune thrombocytopenic purpura (n = 5) and myelosuppression caused by chemotherapy (n = 2). Of 14 girls who underwent a more detailed hemostatic evaluation, 8 were given a diagnosis of a hereditary coagulation disorder: 6 had platelet function defects and 2 had type 1 von Willebrand disease. Excessive menstrual bleeding commonly results in anemia. One half of the total group had anemia (hemoglobin <12.0 g/dL). Seven girls (10%) had potentially life-threatening anemia (hemoglobin <5.0 g/dL).

CONCLUSIONS: Acquired and congenital bleeding disorders are common causes of menorrhagia in adolescent girls. Severe anemia is a frequent complication of menorrhagia. We recommend that adolescents without thrombocytopenia who present with menorrhagia receive a comprehensive hemostatic evaluation, including testing for von Willebrand disease and platelet function defects.

Author List

Bevan JA, Maloney KW, Hillery CA, Gill JC, Montgomery RR, Scott JP

Authors

Robert R. Montgomery MD Emeritus Professor in the Pediatrics department at Medical College of Wisconsin
John Paul Scott MD Emeritus Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Anemia, Hypochromic
Blood Platelet Disorders
Child
Female
Hemorrhage
Humans
Menorrhagia
Retrospective Studies
Thrombocytopenia
von Willebrand Diseases