High prevalence of heavy menstrual bleeding in women with rare bleeding disorders in the Netherlands: retrospective data from the RBiN study

Maas, Dominique P. M. S. M.; Saes, Joline L.; Blijlevens, Nicole M A; Cnossen, Marjon H.; Exter, Paul L. den; Heijden, Olivier W.H. van der; Kruis, Ilmar C.; Meijer, Karina; Peters, Marjolein; Schutgens, Roger E.G.; Nieuwenhuizen, Laurens; Schols, Saskia E. M.

doi:10.1016/j.jtha.2023.07.014

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…In the recent data from the Rare Bleeding Disorders in the Netherlands (RBiN) study (also including some patients with severe factor deficiencies not fitting the definition of MBD), 80% (89/111) of women suffered from HMB. 12 In the large cohort of patients with MBD from the Vienna bleeding biobank, HMB was reported by almost 64.5% of women with MBD, and over 69.0% of women with BDUC. 13 Characteristics of HMB that indicate an underlying MBD include abnormal bleeding since menarche, HMB that requires medical intervention or is nonresponsive to treatment, recurrent ovulation bleeding, iron-deficiency or iron-deficiency anemia, a sensation of flooding, bleeding through sanitary protection within 2 h, and a menstrual period lasting more than 7 days.…”

Section: Personal Bleeding Historymentioning

confidence: 98%

How to investigate mild to moderate bleeding disorders and bleeding disorder of unknown cause

Casini,

Gebhart

2024

Int J Lab Hematology

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A bleeding tendency is one of the most common complaints observed by hematologists. It is challenging to differentiate a clinically insignificant bleeding from a bleeding phenotype that requires hemostatic evaluation and medical intervention. A thorough review of personal and familial history, objective assessment of bleeding severity using a bleeding assessment tool, and a focused physical examination are critical to correctly identifying suspected patients with mild to moderate bleeding disorders (MBDs). A basic laboratory work‐up should be performed in all patients referred for a bleeding tendency. If a hemostatic abnormality is found such as evidence of von Willebrand disease, a platelet function disorder, or a coagulation factor deficiency, more extensive testing should be performed to further characterize the bleeding disorder. Conversely, if all results are normal the patient is considered to have bleeding disorder of unknown cause (BDUC). For patients with BDUC, further evaluation may include non‐routine testing to look for rare bleeding disorders not detected by routine hemostasis tests, such as thrombomodulin‐associated coagulopathy, tissue factor pathway inhibitor‐related bleeding disorder, hyperfibrinolytic‐bleeding disorders or impaired tissue factor production. In this review, we summarize the stepwise diagnostic procedure in MBDs and provide some insights into the biological features of BDUC.

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Section: Personal Bleeding Historymentioning

confidence: 98%

How to investigate mild to moderate bleeding disorders and bleeding disorder of unknown cause

Casini,

Gebhart

2024

Int J Lab Hematology

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Rare bleeding disorders in Egyptian females presented with heavy menstrual bleeding: single-center study

El Demerdash,

El Kholy,

Ayad

et al. 2024

Egypt J Intern Med

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Background Heavy menstrual bleeding is an important health problem in women of reproductive age and is also one of the most common symptoms in women with bleeding disorders. Data about the frequency of rare bleeding disorders are limited, and population-based studies are lacking, so we aimed to determine the frequency of rare bleeding disorders among women presented with heavy menstrual periods that cannot be attributed to obvious problems. Methods Complete blood count and bleeding profiles include activated partial thromboplastin time, prothrombin time, factor VIII activity assay, ristocetin cofactor activity, von Willebrand antigen assay, platelet aggregation tests and other factor assays in 100 out of 300 females presented with unexplained heavy menstrual period, pictorial bleeding assessment chart (PBAC) > 100 as a screening tool for heavy menstrual periods, and or International Society of Thrombosis and Hemostasis-Bleeding Assessment Tool (ISTH-BAT) > 6. Results A total of 300 women with heavy menstrual periods without an obvious explained cause were included in our study. Among them, we found 100 (30%) females with a mean PBAC of 234 ± 147 and mean ISTH-BAT of 9 ± 5 denoting HMB may be due to underlying bleeding disorders. Among them, the most common diagnosis was VWD in 30 (30%). Other disorders were as follows: 28 (28%) cases with clotting factor deficiencies, 24 (24%) cases were found to have platelet dysfunction, and in 18% of our studied cases, we did not find a clear cause of their bleeding disorders (unknown). Conclusion Rare bleeding disorders are not uncommon and require comprehensive hemostatic evaluation as well as simple tools like PBAC and ISTH-BAT questionnaires for the identification of females presented with unexplained HMB.

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High prevalence of heavy menstrual bleeding in women with rare bleeding disorders in the Netherlands: retrospective data from the RBiN study

Cited by 2 publications

References 28 publications

How to investigate mild to moderate bleeding disorders and bleeding disorder of unknown cause

How to investigate mild to moderate bleeding disorders and bleeding disorder of unknown cause

Rare bleeding disorders in Egyptian females presented with heavy menstrual bleeding: single-center study

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