Evaluation of the frequency of abnormal uterine bleedingand von willebrand disease in female adolescents withnutritional anemia

Anemia is an important public health issue worldwide. The increased growth rate with increased metabolic turnover, inappropriate dietary habits, and a history of abnormal uterine bleeding have led to an increased frequency of anemia during adolescence. We aimed to investigate the frequency of iron deficiency and B12 deficiency anemia in adolescent girls and frequency of Von Willebrand Disease in the etiology of anemia during this period. The study included 317 female patients who were diagnosed with anemia and followed up at our Pediatric Hematology Outpatient Clinic between 01.02.2020-01.02.2023. Patient data were obtained retrospectively from medical records. Demographic characteristics, clinical findings, presenting symptoms, laboratory parameters, and the treatments used for these patients were examined in detail. Complete blood count, ferritin, vitamin B12, folic acid, hemoglobin electrophoresis, coagulation parameters, Von Willebrand factor ristocetin, and Factor VIII test results were recorded. The mean age was 14.5±2.1 years. Iron deficiency was found in 41,6% of patients, vitamin B12 deficiency in 21,1%, and combined nutritional anemia in 35.9%. Folic acid deficiency were found in 1,2% of patients. A history of abnormal uterine bleeding was detected in 23.6% of patients. The 78.6% out of 61 patients had no pathological finding in gynecological examination. Von Willebrand Disease type 1 diagnosis was made in 21.3% of patients with regarding Von Willebrand factor, ristocetin, Factor VIII levels, together with clinical findings related to abnormal uterine bleeding In conclusion, although nutritional anemia is frequently observed in the adolescent age group, risk assessment should be performed, especially in patients with abnormal uterine bleeding. Screening programs and much more prevalence studies should be carried out to detect underlying bleeding disorders in these patients at an early stage. Keywords: Adolescent girls, anemia, abnormal uterine bleeding, Von Willebrand disease