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Amenorrhoea and lack of efficacy: case report A 14-year-old girl exhibited lack of efficacy with norethisterone while being treated for heavy menstrual bleeding and she also developed amenorrhoea during treatment with ethinylestradiol and levonorgestrel for immune thrombocytopenia (ITP) [not all routes stated]. The girl, who had her menarche at 12 years of age presented to the gynaecology department with heavy menstrual bleeding from past 3 months. She had been on norethisterone 30mg daily; however no response was observed. Therefore, the girl was investigated at a private centre and received three units of packed erythrocytes [Red Blood Cells] for anaemia with 11 units of platelet for thrombocytopenia. She was then referred for the further management, when she was diagnosed with ITP. Following a diagnosis of ITP, she received oral contraceptive pills including ethinylestradiol [ethinyl oestradiol] 0.03mg and levonorgestrel [levonorgesterol] 0.15mg combination for 3 months. Concomitantly she received tranexamic acid, iron and multivitamin tablets. At 3 months follow-up visit, she informed about an episode of amenorrhoea, which was suspected to be due to continuous ethinylestradiol and levonorgestrel [duration of treatment to reaction onset and outcome not stated]. Following the episode of amenorrhoea, she had a normal menstrual flow. Sharma C, et al. Immune Thrombocytopenia causing Abnormal Uterine Bleeding in an Adolescent Girl having Co-Existent Type-1 Neurofibromatosis- Is it an Association or Coincidence? Journal of Clinical and Diagnostic Research 14: QD01-QD03, No. 11, Nov 2020. Available from: URL: http://doi.org/10.7860/ 803520085 JCDR/2020/45490.14180

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Reactions 12 Dec 2020 No. 1834