MENORRHAGIA;

INHERITED FACTOR-VII DEFICIENCY IN A 12 YEARS OLD GIRL FROM KARACHI

Abstract

Factor VII deficiency is a rare, autosomal recessive coagulopathy that becomes symptomatic in the form of a hemorrhagic
syndrome characterized by severe life threatening bleeding. This may present in young women as severe anemia due to bleeding per
vaginum. We report one such case of a 12 year old girl who presented at the gynecology outpatient department with complaints of severe
menorrhagia at menarche. Her past history was consistent with episodes of profuse epistaxis and bleeding from gums. Her complete
blood count showed severe anemia. Upon further investigation her prothrombin time was prolonged but her APTT was normal which was
indicative of Factor VII deficiency and was confirmed by serum assays of Factor VII. It is important to diagnose this disorder earlier in order
to avoid long term complications especially in women who may suffer from severe life threatening hemorrhage during menses or
recurrent miscarriages during pregnancy. Therefore, our patient was transfused with packed cells and fresh frozen plasma immediately
and started on low dose oestrogen and progesterone pill along with tranexemic acid to control her symptoms.