Severe Menorrhagia

A 15-year-old African-American female presented with prolonged menstrual bleeding accompanied by a 1-week history of weakness, fatigue, dizziness, and bifrontal headaches. Her previous period was 5 weeks earlier, lasted 3 weeks, with heavy passage of clots. Family history is significant for bleeding disorders. Her platelet count was in the 60,000-80,000 range, platelet aggregometry was low, and antiplatelet antibodies positive; she received platelet transfusion that increased and stabilized her platelet count. She was diagnosed with reactive thrombocytosis due to severe iron deficiency anemia. She was placed on ethynil estradiol plus norethindrone therapy until her platelet count rose to 2,275,000.