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Posted On : 19 Feb 2023

The baby admitted on 2nd day of life with history of neonatal asphyxia the baby was observed and the was no abnormal neurological signs. The baby was discharged but came after 3 days with bleeding from cannula sites. PT 80 PTT 45 INR 8. The baby received plasma and there was a slight improvement in a lab setting and the baby was in well condition. After 1-week the baby had sepsis from the umbilical catheter was removed and the received Vancomycin plus meronem. CBC showed severe thrombocytopenia and received platelet. Thrombin time was prolonged d-dimer was positive. SGPT SGOT was normal after 2 weeks the baby was stable after receiving high doses of plasma. 1 month later the bleeding comes again. Factors 2,7,10 were low. What is your diagnosis? The baby was now admitted to PICU with intracranial hemorrhage.

Expert Answer :

Answer Discussion :

L

Lokesh Naik

0

VKD Bleeding

1 year ago

M

MOHAN KEJRIWAL

0

14 months 9 kg male with history of fever 25 days,initially had loose stools. Present tempr 104.8 F, TLC-23850,N70%, Platelet 1067000/mm3, CRP 72.82,ESR-113 mm. Has reddish oral mucosa, help in diagnosis needed.

1 year ago

J

Jitendra Jha

0

peletles ko Kam karne ki medicine

1 year ago

J

Jitendra Jha

0

w bc ko Kam karne wali medicine

1 year ago

S

satywan verma

0

Haemophilia

1 year ago

Answer 1

There is prolonged PT, PTT, TT Thrombocytopenia and D Dimer is plusve. All this is Suggestive of DIC sec to both asphyxia and Sepsis. The drug can cause thrombocytopenia and prolonged coag profile by Vit K Dependent coag factor. I presume VIT K was already given. Gamma Carboxylation defect or VKOR enzyme deficiency is also a possibility but cannot explain thrombocytopenia and elevated D Dimer. Do PIVKA levels.

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