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Lessons from a neonate with unusual bleeding

Lessons from a neonate with unusual bleeding AbstractHealthy, term neonates rarely encounter problems with bleeding, despite physiological differences in their levels of clotting factors, reflected in prolongation of the prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT). Their risk of bleeding, however, is significantly increased by the presence of a severe congenital bleeding disorder. Establishing such a diagnosis can present a particular challenge, given the rarity of these conditions and the difficulty in performing and interpreting laboratory assays in this age group. However, a delay in diagnosis and implementation of appropriate treatment can result in catastrophic sequelae. Therefore, the presentation of a healthy child at birth, whose condition rapidly deteriorates as a result of bleeding, should prompt the urgent investigation of a congenital haemostatic defect and involvement of expert haematological advice. We describe a very unusual presentation of a severe bleeding disorder in the first few days of life to highlight these issues. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Journal of Haemophilia Practice de Gruyter

Lessons from a neonate with unusual bleeding

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Publisher
de Gruyter
Copyright
© 2016 Emma Fosbury, Raoul Blumberg, Ri Liesner, Keith Sibson, published by Sciendo
eISSN
2055-3390
DOI
10.17225/jhp00064
Publisher site
See Article on Publisher Site

Abstract

AbstractHealthy, term neonates rarely encounter problems with bleeding, despite physiological differences in their levels of clotting factors, reflected in prolongation of the prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT). Their risk of bleeding, however, is significantly increased by the presence of a severe congenital bleeding disorder. Establishing such a diagnosis can present a particular challenge, given the rarity of these conditions and the difficulty in performing and interpreting laboratory assays in this age group. However, a delay in diagnosis and implementation of appropriate treatment can result in catastrophic sequelae. Therefore, the presentation of a healthy child at birth, whose condition rapidly deteriorates as a result of bleeding, should prompt the urgent investigation of a congenital haemostatic defect and involvement of expert haematological advice. We describe a very unusual presentation of a severe bleeding disorder in the first few days of life to highlight these issues.

Journal

The Journal of Haemophilia Practice – de Gruyter

Published: Jan 1, 2016

References

  • Neonatal bleeding in haemophilia: a European cohort study
  • Neonatal coagulation problems
  • Treatment and prevention of acute bleedings in von Willebrand disease – efficacy and safety of Wilate, a new generation of von Willebrand factor /factor VIII concentrate
  • Neonatal coagulation problems
  • Von Willebrand disease and pregnancy
  • Guideline on the management of haemophilia in the fetus and neonate
  • Von Willebrand disease and pregnancy
  • Neonatal bleeding in haemophilia: a European cohort study
  • Guideline on the management of haemophilia in the fetus and neonate
  • Treatment and prevention of acute bleedings in von Willebrand disease – efficacy and safety of Wilate, a new generation of von Willebrand factor /factor VIII concentrate