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

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 introduces nine 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 imaging and/or histopathological examination, while “COEIN” includes non-structural abnormality.

CASE REPORT

A 17-year-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 by the patient since 5 months ago. The patient claimed to have had menstruation for 10−14 days, 4−5 times changing pads. Gynecology examination was within normal limits. Blood analysis has been done 3 times and the results came up with a significant decrease of platelet counts and hemoglobin levels.

Transabdomen 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.