An Intriguing Case of Congenital Coagulopathy: Presenting as Intracranial Haemorrhage in a Term Neonate.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2017, Vol 2, Issue 6
Abstract
Congenital coagulopathy leading to intracranial haemorrhage (ICH) is rarepresentation with the overall incidence still unknown, owing to a number of asymptomatic cases and the varying sensitivity of the neuroimaging procedures used for diagnosis. We present a case of ICH in a twenty five day old term neonate who was referred to our institute with complaints of lethargy, fever and vomiting. The patient was markedly pale with tense and bulging anterior fontanelle. Neuroimaging (CT scanbrain) revealed bilateral acute on chronic subdural haemorrhage. Coagulation profile was indicative of an isolated prolongation of prothrombin time (PT) with a normal activated partial thromboplastin time (APTT) signifying an extrinsic pathway disorder following which Factor VII assay clinched our diagnosis of Factor VII deficiency. The patient was treated with intravenous Vitamin K along withfresh frozen plasma transfusions considering the non-availability of Factor VII concentrate or activated recombinant Factor VII concentrate. Preliminary family screening with PT was normal and the child was discharged with counselling regarding immediate home based acute post seizure care and the importance of avoiding even trivial traumatic episodes.
Authors and Affiliations
Sushma Malik
Keywords
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