Giacchetti Lorenzo, De Gaudenzi Martina, Leoncini Andrea, Ferrucci Elisabetta, Pezzoli Valdo, Albisetti Manuela
Department of Pediatrics, Regional Hospital of Lugano, Via Tesserete 46, 6900, Lugano, Switzerland.
Department of Pediatrics, University of Pavia, Pavia, Italy.
J Med Case Rep. 2017 Aug 28;11(1):248. doi: 10.1186/s13256-017-1414-0.
Fetal thrombotic vasculopathy is a described placental diagnosis associated with adverse perinatal outcomes. It may also predispose children to somatic thromboembolic events. As far as we know, this is the first case of inferior vena cava thrombosis associated with fetal thrombotic vasculopathy in a completely asymptomatic newborn.
We report the case of an asymptomatic, full-term Turkish male neonate delivered at 39 weeks of gestation diagnosed as having thrombosis of the renal vein and inferior vena cava. Diagnosis was guided only by the presence of edematous umbilical cord with macroscopic signs of clotting and, subsequently, microscopic features of the placenta, suggesting fetal thrombotic vasculopathy.
Thrombosis of the renal and inferior vena cava in our healthy, asymptomatic full-term neonate is clearly associated with fetal thrombotic vasculopathy. The diagnosis of thrombosis in this neonate was incidental. This suggests that fetal thrombotic vasculopathy may cause unrecognized neonatal thrombosis. Untreated neonatal thrombosis may later compromise growth and function of the involved organs; therefore, maintaining a high index of suspicion based on thrombotic vasculopathy is paramount.
胎儿血栓性血管病是一种已被描述的胎盘诊断,与不良围产期结局相关。它还可能使儿童易患体循环血栓栓塞事件。据我们所知,这是首例在完全无症状的新生儿中发生的与胎儿血栓性血管病相关的下腔静脉血栓形成病例。
我们报告了一例无症状的足月土耳其男婴病例,该婴儿在妊娠39周时出生,被诊断为肾静脉和下腔静脉血栓形成。诊断仅依据水肿脐带伴有肉眼可见的凝血迹象,以及随后胎盘的微观特征,提示胎儿血栓性血管病。
我们健康、无症状的足月新生儿出现肾静脉和下腔静脉血栓形成,显然与胎儿血栓性血管病相关。该新生儿血栓形成的诊断是偶然发现的。这表明胎儿血栓性血管病可能导致未被识别的新生儿血栓形成。未经治疗的新生儿血栓形成可能会在以后损害受累器官的生长和功能;因此,基于血栓性血管病保持高度怀疑指数至关重要。