What to Include in a GT Emergency Letter
At a Glance
A Glanzmann Thrombasthenia emergency letter must be drafted by a hematologist and include your exact diagnosis, baseline blood counts, and antibody status. Crucially, it must detail safe treatments like rFVIIa or tranexamic acid, and list strict warnings to avoid NSAIDs and intramuscular injections.
In this answer
5 sections
An emergency letter for Glanzmann Thrombasthenia (GT) must provide critical, at-a-glance information for non-expert healthcare providers treating you during a severe bleed or trauma [1]. Your hematologist or treatment center must be the one to draft, calculate specific medical dosages for, and sign this official document. The essential components include your exact diagnosis, baseline blood counts, antibody/alloimmunization status, direct 24/7 contact for your hematologist, and clear clinical instructions on what to administer and what to strictly avoid [1][2].
Core Patient and Medical Information
Your letter must clearly state your exact diagnosis, including your specific GT subtype [3][4]. These subtypes (Type I, Type II, or Variant) generally refer to how much functional platelet protein you have, though bleeding severity can still vary widely from person to person [5]. While GT is typically characterized by normal platelet counts with impaired function, your letter should list your baseline platelet count, baseline hemoglobin, and your blood type (ABO/Rh) [6]. During a major hemorrhage, emergency departments need your blood type immediately if you require red blood cell transfusions. Additionally, certain rare variant forms of GT present with macrothrombocytopenia, a condition where platelets are both dysfunctional and lower in number [7]. Providing these baselines helps emergency doctors interpret your blood work quickly and accurately.
Alloimmunization and Antibody Status
Perhaps the most crucial clinical detail your doctor will include is your alloimmunization status—whether you have developed antibodies against platelets (such as anti-HLA or anti-αIIbβ3 antibodies) [2][8]. Because platelet transfusions are often a first-line treatment for acute bleeding, repeated exposure can cause the body to create antibodies that destroy the transfused platelets, leading to a state known as platelet refractoriness [9][10]. Knowing your antibody status dictates whether emergency doctors should attempt a standard platelet transfusion or move directly to alternative treatments [11].
What to Administer (Treatment Protocols)
Your hematologist’s letter should provide strict, clear guidelines on what treatments to administer during a bleeding crisis:
- Recombinant activated factor VII (rFVIIa): This is a highly effective, safe alternative to platelet transfusions, especially for patients with a history of platelet refractoriness or known antibodies [12][13]. Because rFVIIa has a very short half-life, the letter must clearly state your precise dosage based on your weight, as well as the strict dosing frequency and intervals required to prevent breakthrough bleeding [14].
- Platelet Transfusions: If you do not have antibodies, platelet transfusions may be indicated for severe bleeding. The letter should emphasize using HLA-matched platelets when possible and avoiding unnecessary transfusions to prevent the development of new antibodies [9][15].
- Antifibrinolytics: Medications like tranexamic acid (TXA) or aminocaproic acid help stabilize blood clots [16][17]. These can be given systemically (IV or oral) or applied topically—such as TXA-soaked gauze for stubborn nose or mouth bleeds [18][19].
What to Strictly Avoid (Contraindications)
Emergency rooms frequently use standard protocols that are highly dangerous for GT patients. The letter must explicitly list contraindicated treatments:
- NSAIDs and Aspirin: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen significantly impair platelet function and increase the risk of severe hemorrhage [9][20]. For pain relief, alternatives like acetaminophen are preferred [9].
- Intramuscular (IM) Injections: IM injections must be strictly avoided as they can cause deep, large, and painful hematomas (blood clots deep in the muscle tissue) [9][21]. Medications should be given via intravenous (IV) or subcutaneous (under the skin) routes instead [21].
Care Team Contact Information
Finally, your letter must include direct, 24/7 contact information for your primary hematologist or Hemophilia Treatment Center (HTC) [2][22]. Emergency medical alert tools facilitate rapid multidisciplinary decision-making, ensuring that emergency room doctors can coordinate immediately with experts familiar with your rare condition [1][23].
Common questions in this guide
Why do I need an emergency letter for Glanzmann Thrombasthenia?
What medications should be strictly avoided if I have Glanzmann Thrombasthenia?
Why is antibody or alloimmunization status important on my emergency letter?
Who should draft and sign my Glanzmann Thrombasthenia emergency letter?
Questions for Your Doctor
5 questions
- •Can you draft and sign an official emergency letter that includes my specific GT subtype, baseline labs (including hemoglobin and blood type), and alloimmunization status?
- •What are the exact weight-based dosages and dosing intervals for rFVIIa and tranexamic acid (TXA) that you will list on the letter?
- •How frequently should we retest for platelet antibodies to ensure the treatment instructions on the letter remain accurate?
- •What is the most direct 24/7 emergency phone number for the on-call hematologist at our treatment center?
- •Are there specific "treat immediately" scenarios, like a head injury, where you want the emergency room to administer rFVIIa before waiting for scans?
Questions for You
3 questions
- •Is my current emergency letter officially signed by my hematologist, or do I need to request an updated one?
- •Where do I plan to keep physical copies of this letter (e.g., wallet, car, school, workplace) so it is always accessible to first responders?
- •Have I considered wearing a medical ID bracelet that directs paramedics to look for my emergency letter?
References
References (23)
- 1
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Fiore M, Giraudet JS, Alessi MC, et al.
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PMID: 37386449 - 2
High Rates of Anti-αIIbβ3 Antibodies Produced by a Glanzmann Thrombasthenia Patient after First and Unique Red Blood Cells Administration.
Huguenin Y, Levoir L, Bouton M, Fiore M
Acta haematologica 2023; (146(1)):44-46 doi:10.1159/000526224.
PMID: 36103848 - 3
Novel mutations in Thai patients with glanzmann thrombasthenia.
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PMID: 35218677 - 5
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Lee A, Maier CL, Batsuli G
Haemophilia : the official journal of the World Federation of Hemophilia 2022; (28(4)):633-641 doi:10.1111/hae.14559.
PMID: 35412688 - 7
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Journal of thrombosis and haemostasis : JTH 2019; (17(12)):2211-2215 doi:10.1111/jth.14622.
PMID: 31565851 - 8
Independent adjudicator assessments of platelet refractoriness and rFVIIa efficacy in bleeding episodes and surgeries from the multinational Glanzmann's thrombasthenia registry.
Recht M, Rajpurkar M, Chitlur M, et al.
American journal of hematology 2017; (92(7)):646-652 doi:10.1002/ajh.24741.
PMID: 28370369 - 9
How we treat the platelet glycoprotein defects; Glanzmann thrombasthenia and Bernard Soulier syndrome in children and adults.
Grainger JD, Thachil J, Will AM
British journal of haematology 2018; (182(5)):621-632 doi:10.1111/bjh.15409.
PMID: 30117143 - 10
Eptacog alfa activated: a recombinant product to treat rare congenital bleeding disorders.
Di Minno G
Blood reviews 2015; (29 Suppl 1()):S26-33.
PMID: 26073366 - 11
Anti-αIIb β3 immunization in Glanzmann thrombasthenia: review of literature and treatment recommendations.
Fiore M, d'Oiron R, Pillois X, Alessi MC
British journal of haematology 2018; (181(2)):173-182 doi:10.1111/bjh.15087.
PMID: 29611179 - 12
The international, prospective Glanzmann Thrombasthenia Registry: treatment modalities and outcomes of non-surgical bleeding episodes in patients with Glanzmann thrombasthenia.
Di Minno G, Zotz RB, d'Oiron R, et al.
Haematologica 2015; (100(8)):1031-7 doi:10.3324/haematol.2014.121475.
PMID: 26001793 - 13
The international, prospective Glanzmann Thrombasthenia Registry: treatment and outcomes in surgical intervention.
Poon MC, d'Oiron R, Zotz RB, et al.
Haematologica 2015; (100(8)):1038-44 doi:10.3324/haematol.2014.121384.
PMID: 26001792 - 14
Low Concentrations of Recombinant Factor VIIa May Improve the Impaired Thrombin Generation of Glanzmann Thrombasthenia Patients.
Levy-Mendelovich S, Levy T, Budnik I, et al.
Thrombosis and haemostasis 2019; (119(1)):117-127 doi:10.1055/s-0038-1676348.
PMID: 30597506 - 15
Outcomes of recombinant activated factor VIIa (NovoSeven) therapy in glanzmann thrombasthenia: two case reports.
Almatar E, Alsharidah S, Hashem OA
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis 2025; (36(6)):293-295 doi:10.1097/MBC.0000000000001380.
PMID: 40673721 - 16
Two case reports of Glanzmann thrombasthenia with intracranial hemorrhage and a review of the literature.
Almesedin GS, Alshmaily HO, Alshammari KA, Albalawi RS
Surgical neurology international 2023; (14()):448 doi:10.25259/SNI_680_2023.
PMID: 38213436 - 17
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Glanzmann Thrombasthenia: Use of the Soft Splint with Tranexamic Acid Paste to Reduce Spontaneous Oral Bleeding.
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One day at a time: Life with Glanzmann thrombasthenia - Qualitative results from the GT 360 study.
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Management of pregnancy and childbirth in Glanzmann thrombasthenia: A case series and review.
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PMID: 31085914
This page provides educational information about emergency letters for Glanzmann Thrombasthenia. Always work with your primary hematologist to draft, calculate dosages for, and sign your official emergency document.
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