Case Report: Abnormal Ute...

A 14-year-old presented with early menarche at 10, irregular periods, and has experienced abnormal uterine bleeding (AUB) for 15 days and presents with functional anaemic syndrome. At the time of presentation, her BMI was 34 kg/m2, her skin and mucous membranes were pale without haemorrhagic lesions, and her BP was 110/70 mmHg. Genitalia Tanner Stage V, with no abnormalities observed. She experienced moderate, non-odorous bleeding. Blood tests revealed iron-deficiency anaemia (Hb 6.8 g/dl), necessitating two transfusions. Liver function, blood clotting factors, Von Willebrand Factor, and platelet aggregation tests were normal. She continued to exhibit significant genitourinary enlargement. Treatment involved Tranexamic acid 1g IV every 8 hrs and ethinylestradiol 20mg/Levonorgestrel 0.1mg (OCP) every 6 hrs until bleeding ceased, then the patient was transitioned to OCP 1 pill/day. She was discharged with minor bleeding but experienced recurrence at 6 days. Hormonal treatment resumed, along with Leuprolide acetate 7.5mg once in 3 months. Also, a CT scan suggested hematometra, and hysteroscopy revealed intracavitary clots.1