Bernard-Soulier Syndrome (BSS) & tuberculosis: A case report

Bernard-Soulier Syndrome (BSS) is a rare congenital bleeding disorder characterized by thrombocytopenia. BSS causes bruising, epistaxis, gingival bleeding hemorrhage, post-partum bleeding, gastrointestinal bleeding and post-traumatic hemorrhage, but there is no report of hemoptysis in BSS.

A 14-year-old girl was referred to this center due to massive hemoptysis. Her chest X-ray revealed complete collapse of the left lung. Rigid bronchoscopy was performed and the intrabronchial clots were removed. Smear and culture of direct sputum was positive for Mycobacterium tuberculosis. She received anti-tuberculosis treatment. During treatment, she developed massive vaginal bleeding, because of drug interaction between rifampin and low dose contraceptive (LD), which she had been taking for control of massive menstrual bleeding. Her vaginal bleeding was controlled by platelet infusion and recombinant factor 7 infusion. After two months of anti-TB treatment, the sputum smear and culture examination became negative. One year after treatment, the pulmonary tuberculosis was completely cured and no hemoptysis occurred.

When hemoptysis occurs in patients with BSS, other differential diagnoses should also be considered.