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Abnormal uterine bleeding: an insidious presentation
  1. Teresa Almeida Lopes1,
  2. Marta Martins Carvalho2,
  3. Nádia Brito2 and
  4. Catarina Neves1
  1. 1Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
  2. 2Serviço de Pediatria, Hospital Distrital da Figueira da Foz, Figueira da Foz, Portugal
  1. Correspondence to Dr Teresa Almeida Lopes; teresalopes26{at}


An adolescent was referred to the emergency department due to abnormal uterine haemorrhages in the previous 2 months, associated with dizziness in the last month. At observation, she was haemodynamically stable, with good clinical impression, but evident mucocutaneous pallor. Full blood count confirmed a severe anaemia (haemoglobin 47 g/L). She received red blood cell transfusion (10 mL/kg) and started oral oestradiol. She was discharged, with oral oestradiol and oral iron supplementation. Two weeks later, she started treatment with oestradiol and progestin. The patient had a good recovery, without new similar episodes.

  • Haematology (incl blood transfusion)
  • Obstetrics and gynaecology
  • Paediatrics

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  • Contributors TAL is the main author of this case report and has contributed significantly to the conception, analysis and interpretation of the data presented in this report. As the corresponding author, she has taken responsibility for the overall content and ensured that it meets the journal’s requirements. MMC has also played an important role in the development of this case report. She has assisted in drafting the work, revising it critically for important intellectual content, and has given her final approval of the version to be published. NB and CN have also contributed significantly to this case report by revising it critically for important intellectual content and have provided their final approval of the version to be published. All authors have read and approved the final version of the manuscript and take responsibility for its content. We confirm that the manuscript represents an honest, accurate and transparent account of the study being reported and that no important aspects of the study have been omitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.