Challenges in Managing AUB-C in Adolescence with Acute Lymphoblastic Leukemia in North Sumatera, Indonesia: A Case Report

Muhammad Fidel Ganis Siregar; R. S. Tambunan

doi:10.3889/oamjms.2023.11059

Authors

Muhammad Fidel Ganis Siregar Division of Fertility and Reproductive Endocrinology, Department of Obstetrics and Gynecology, Faculty of Medical, Universitas Sumatera Utara, Medan, Indonesia
R. S. Tambunan Department of Obstetrics and Gynecology, Faculty of Medical, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-0653-9985

DOI:

https://doi.org/10.3889/oamjms.2023.11059

Keywords:

Abnormal uterine bleeding, Acute lymphoblastic leukemia, Menstrual bleeding, PALM-COEIN

Abstract

Background : Abnormal Uterine Bleeding is a common problem not only cause health disturbance but also affect the physical, social, emotional status, and quality of life of a women. The most common symptom is abnormally heavy or prolonged uterus bleeding. FIGO introduce 9 categories cause of abnormal uterine bleeding, which are known as “PALM- COEIN”. In general, components in “PALM” are components of structural abnormality, which can be diagnosed by imagingand/or histopathological examination. While “COEIN” includes non-structural abnormality.

Case Report: A 17 years old female without a history of sexual intercourse came to the gynecology polyclinic of the University Of North Sumatra hospital with a chief complaint of irregular menstruation that had been experienced bythe patient since 5 months ago. The patient claimed to have had menstruation for 10-14 days. 4-5 times changing pads. Gynaecology examination within normal limits. Blood analysis has been done 3 times and the results came up with asignificant decrease of platelet counts and Haemoglobin levels.

Trans Abdomen Ultrasonography was done and showed no abnormality found. The patient was diagnosed with AUB-C in Acute lymphoblastic leukemia.

Conclusion: Abnormal uterine bleeding (AUB) is a common finding in women during their reproductive years. There are steps on how to diagnose an abnormal uterine bleeding disorder (AUB) based on comprehensive history taking, followed by a physical and additional workup.

Keywords: Abnormal uterine bleeding, acute lymphoblastic leukemia, menstrual bleeding, PALM- COEIN.

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