Question of the Week

Question :
Posted On : 02 Aug 2011
This is a 45 day old child who is on mothers milk and thriving well was brought to my office for vaccination.On general examination i have noticed ecchymotic patches on abdomen and back and small patches on knees which according to parents have been waxing and waning since birth,baby also has icterus,liverspan is normal.Ihave deferred vaccination and have ordered certain blood investigations{hb percent10.8,hct35.8,platelet count 2,40,000,prolongedPT -32 sec ,APTT normal,BT and CTnormal,liver function test revealed increased conjugated bilurubin 7.1and elevated sgot 114,u, s abdomen normal.What further tests should be done to come to diagnosis_?is proteinC AND S,CLOTTING FACTOR ASSAYS useful,how should i manage_? should i vaccinate_?
from dr.suman
0
Expert Answer :
Since PT is prolonged and the child has liver dysfunction, one should rule out neonatal cholestasis and its causes. Give Vitamin K and other fat soluble vitamins in cholestatic doses. Protein C and S levels are deficient in liver diseas. Clotting factor assay will not be useful.
Answer Discussion :
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