Neonatal asphyxia and renal failure as the presentation of non-inherited protein C deficiency

Y. Matsunaga, S. Ohga, T. Kinjo, M. Ochiai, N. Ito, T. Doi, D. Kang, T. Hara

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Inherited or acquired protein C (PC) deficiency leads to thromboembolic events. Plasma PC activity in infancy is physiologically lower than in adults. We describe a case of neonatal asphyxia and acute renal failure associated with isolated PC deficiency. A full-term male infant was born to a healthy mother by caesarean section because of fetal distress. The small-for-gestational age infant showed 2 and 7 of Apgar scores at 1 and 5 minutes, respectively. Hypercoagulability required repeated infusions of fresh frozen plasma. Coagulation study revealed PC activity, 6%, protein S activity, 61%, and high D-dimer levels, along with normal factor VII activity and absent vitamin K deficiency. Anticoagulant and activated PC therapy improved coagulopathy and nephropathy. Imaging analyses indicated no visceral infarctions. Renal function and PC activity have been slowly normalized until 6 months of age. He had no PROC mutation or PC-deficient parents. Selective PC deficiency may occur as an acquired cause of hypercoagulable crisis in the stressed newborn.

Original languageEnglish
Pages (from-to)239-241
Number of pages3
JournalJournal of Perinatology
Volume33
Issue number3
DOIs
Publication statusPublished - Mar 2013

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

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