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2017, Number 5

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Rev Fac Med UNAM 2017; 60 (5)

Treatment for neonatal fulminans purpura. Case report and literature review

Cruz HV, Escárraga VYS, León TS, Cruz ADA, Majluf CAS

Language: Spanish
References: 19
Page: 17-21
PDF size: 580.50 Kb.


ABSTRACT

Neonatal Purpura Fulminans (PF) is an infrequent hypercoagulable state but very severe. Its clinical manifestation is sudden with purpuric-necrotic injuries. It can leave permanent sequels or even have a fatal evolution. It is characterized by thrombosis in the skin’s microcirculation, accompanied with perivascular hemorrhage. The most affected areas are the pelvic and thoracic limbs, and pressure zones. The most common molecular alteration is the protein C defect, which physiologically regulates coagulation; the defect can be of a primary or secondary cause.
Case report: A male newborn with 8 days of extrauterine life suddenly presents oral rejection, irritability and a 39º C fever. Two days later, he was hospitalized for dehydration and oral rejection. He didn’t show signs of fever or infection at the time of his admission. Twenty-four hours after his entry, he presented purpuric-necrotic injuries in the right foot, hence, he was diagnosed with purpura fulminans. D-dimer studies and doppler ultrasound were taken. They confirmed venous and arterial thrombosis. The treatment was initiated with fresh frozen plasma, an anticoagulant and an antiplatelet, with a good response.
Conclusion: PF is a serious hypercoagulable state that requires an early diagnosis and therapy to improve the outcome.


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