To improve our detection Selleckchem C646 of bleeding disorders in young women, Nationwide Children’s Hospital started a multidisciplinary Adolescent Haematology Clinic in February 2009. In this clinic, adolescents are evaluated by a paediatric haematologist and an adolescent medicine specialist. The objective of this study was to describe the demographic characteristics, menstrual bleeding patterns, final diagnoses and prescribed interventions in a referral

population of adolescents with HMB. We hypothesized that the frequency of previously undiagnosed bleeding disorders would be substantial among adolescents referred to this clinic. We performed a retrospective review of the medical records and menstrual bleeding questionnaires of patients between 8 and 18 years of age without a known bleeding disorder who were referred for HMB to the Multidisciplinary Adolescent Haematology Clinic at Nationwide Children’s Hospital between February 2009 and December 2011. In this study, we did not use any objective criteria to

define HMB, and all referred patients were included in the analysis. Clinical and laboratory information was extracted from electronic and paper medical records. Data collected included the age of the patients at time of initial evaluation, the referral catchment area and the specialty of the referring physician. The presence of iron BGB324 solubility dmso deficiency anaemia, eventual diagnoses of bleeding disorders and the prescribed interventions were also ascertained. At the time of their initial visit, all patients were provided a menstrual bleeding questionnaire based on the Ruta Menorrhagia Severity Scale [8]. Using these questionnaires, the menstrual bleeding profiles of those with and without a diagnosis of a bleeding disorder were

analysed using the chi-squared test, with P < 0.05 considered statistically significant. In cases when the cell sizes became too small to reliably use the chi-squared test, the Fisher's exact test was used. Individuals with a von Willebrand factor antigen cAMP level and/or a von Willebrand factor ristocetin co-factor activity of less than 40% were given a diagnosis of vWD, irrespective of their blood type. The diagnosis of platelet storage pool deficiency (PSPD) was made using platelet electron microscopy (EM). Platelets were examined ultrastructurally using the whole mount as described by White et al. [9]. At our institution, delta-granule storage pool deficiency is defined as an average of 3.68 delta granules per platelet or less. Platelet aggregation studies were not uniformly performed but ordered at the discretion of the treating physician. Patients with normal platelet EM but abnormal platelet aggregation studies were labelled as other platelet function defects. Patients with clinical suspicion of Ehlers-Danlos Syndrome (EDS) were referred to the Genetics Clinic where the eventual diagnosis was made. All data analysis was conducted using SAS 9.2 (SAS Institute Inc, Carp, NC, USA).