Colonoscopy polypectomy management in Glanzmann’s thrombasthenia

Abstract

Glanzmann's thrombasthenia (GT) is a rare autosomal recessive bleeding syndrome characterized by abnormal Glycoprotein IIb/IIIa complex (GIIb/IIIa) on platelets with resultant abnormality in platelet aggregation. There is very little information regarding polypectomy management in GT. We report a single patient with this rare disease, who underwent sequential endoscopic management of large colon polyps. Polypectomy in our GT patient was complicated by immediate and delayed bleeding. Multiple clips used after standard cautery polypectomy for a polyp 10 mm or larger in our GT patient, was most effective in preventing immediate and delayed post-polypectomy bleeding than other known therapeutic approaches. We favor preemptive use of multiple clips in large polypectomy defects for GT patients and we may argue the added cost may be offset by the reduction in the need for blood products, and by averting or shortening potential hospitalizations.

A novel homozygous missense mutation in the factor VII gene of severe factor VII deficiency in a pedigree: a description of two cases

“…4-8 days). Moreover, placement of a prophylactic clip on the mucosal wound after polyp resection is reported to be especially effective in selected patients at a high risk of bleedingincluding Glanzmann's thrombasthenia [6,9]. Considering the higher incidence of haemorrhages observed after SP or EMR in our patients, we now systematically combine prophylactic clip place-ment for closure of mucosal wounds with longer postoperative clotting factor treatment.…”

Management of Abdominoperineal Excision of the Rectum in a Patient with Glanzmann Thrombasthenia

“…No cases of elective high-risk abdominal surgery were identified. A series of 4 cases of polypectomy are included, all of which were carried out successfully with platelet cover [13]. A further report of GT diagnosis post-mortem due to haemorrhagic pericarditis has been excluded [3].…”