Intraoperative Bleeding During Mammoplasty and Dermolipectomy: A Case of Glanzmann's Thrombasthenia

Introduction: Glanzmann's thrombasthenia (GT) is a rare bleeding disorder caused by quantitative or qualitative deficiencies of the αIIbβ3 fibrinogen receptor on platelets. Platelet count and morphology are typically normal, but there is dysfunction in platelet aggregation. The global incidence is approximately 1 in 1,000,000 individuals. GT can lead to severe hemorrhages, particularly in post-traumatic or perioperative settings. Objective: To describe the management of a case of GT diagnosed following intraoperative bleeding during mammoplasty and dermolipectomy. Methodology: The study presents an epidemiological design of the descriptive observational type, involving analysis of the patient's medical records. Approval was obtained from the Human Research Ethics Committee. The case description adhered to the precepts outlined in the CARE Guideline. Case description: A 33-year-old female Caucasian with non-consanguineous parents presented to a specialized hematology consultation with complaints of bleeding during mammoplasty and dermolipectomy. Laboratory tests, including a detailed coagulogram and platelet aggregometry, were performed. The results were conclusive for GT, leading to targeted management. Discussion: The platelet light transmission aggregometry test serves as the gold standard for diagnosing GT. Early recognition of the condition is crucial to prevent severe bleeding episodes. Currently, there is no cure for GT, and treatment strategies vary based on the severity of the case. Platelet transfusion remains the most commonly employed method, while the use of activated recombinant factor VII (rFVIIa) shows promise in reducing both the frequency and severity of bleeding episodes.