Case 131

1. Prepared by Sintawat Wangsiricharoen, MD and reviewed by Ivo Francischetti, MD, PhD.

The patient is a adult pregnant woman who is being for evaluation of a bleeding disorder. Her previous medical history includes positive antinuclear antibodies (homogeneous and centromere patterns) and gestational autoimmune liver disease, for which she receives IVIG during pregnancy as a preventative measure. She had no bleeding tendency until she was 30 years old, when she began to have prolonged epistaxis, which caused severe anemia. She denies any history of menorrhagia and has had previous cesarean sections without untoward bleeding. Her family history is negative for von Willebrand disease and hemophilia.

The platelet aggregometry suggests there may be an interference of which platelet receptor?