Acute Life-Threatening Hemorrhage in Neonates With Severe Hemophilia A: A Report of 3 Cases. (September 2018)

• Record Type: Journal Article
• Authors: Moreira, Alvaro; Das, Hrishikesh
• Is Part Of: Journal of investigative medicine high impact case reports. Volume 6(2018)
• Publication Date: 2018-09
• Subjects: hemophilia -- neonates -- clotting factor -- intracranial hemorrhage -- splenic rupture; Internal medicine -- Periodicals; Medical care -- Periodicals; 616.005
• DOI: 10.1177/2324709618800349
• Languages: English
• ISSNs: 2324-7096

Abstract

Hemorrhagic shock is a rare, emergent condition that is often fatal in newborns. In this article, we report cases of 3 neonates presenting with acute, life-threatening hemorrhage who were subsequently diagnosed with severe hemophilia (<1% factor VIII). The first infant was tachycardic, pale, and had a precipitous drop in his hemoglobin secondary to a subgaleal hemorrhage. The second patient sustained a splenic rupture, a sequela that has been reported in only 4 other neonatal cases. The last infant presented with tonic-clonic seizures and respiratory distress. Head imaging demonstrated extracranial and intracranial hemorrhage, complications that can result in 20% mortality. All 3 patients were successfully treated with clotting factor concentrate and blood products. After normalization of factor VIII levels, the newborns did not develop any new hemorrhages and were discharged home within 3 weeks of birth. Pediatric providers should be aware that these signs and symptoms may be potentially lethal complications in neonates with severe factor VIII deficiency.