Excessive uterine bleeding in a patient with functional thrombopathy associated with chronic kidney disease. About a case

Abstract

We report an adolescent with chronic kidney disease due to rapidly progressive glomerulonephritis undergoing hemodialysis treatment who presented excessive uterine bleeding. The anamnesis collected did not show a family history of hemorrhagic diathesis, however, during the pediatric age he had had a tendency to present ecchymosis in light and moderate traumas, occasional nocturnal epistaxis and prolonged bleeding after the loss of primary teeth, for which reason it was suspected. the possibility of a disorder of platelet function and aggregation. The coagulogram was normal, but the qualitative study of the platelets showed an aggregation disorder with ADP, epinephrine and collagen. No extrinsic factors dependent on the treatment of her underlying disease were verified that could potentially contribute to this platelet alteration and it was concluded that she was a patient with probably congenital thrombopathia, who, when added to the platelet toxicity typical of the uremic state, developed this hemorrhagic tendency. , which was controlled with transfusion of red blood cells and platelets associated with antifibrinolytic treatment. The relevance of this patient consists in showing how chronic kidney disease can contribute to the clinical expression of a hematological disease that had remained subclinical after childhood and the need to take this association into account when faced with the diagnostic problem of a hemorrhagic diathesis. in patients with this disorder.