Dehydration as a Rare Cause of Pulmonary Artery Thrombosis in a 2-Week-Old Term Neonate

Abstract

Pulmonary arterial thrombosis is an extremely rare occurrence in the neonatal population. We describe a 2-week-old female neonate who presented in critical condition with severe cyanosis and dehydration and was found to have a large thrombus in the main branches of the pulmonary arteries. She was successfully treated with surgical embolectomy. Pulmonary arterial thrombosis should always be considered in the differential diagnosis of a dehydrated neonate presenting with severe cyanosis and evidence of pulmonary hypertension.

Keywords

pulmonary arterial thrombosis - neonate - dehydration - cyanosis - pulmonary hypertension

• References

• 1 Stevenson GF, Stevenson FL. Pulmonary embolism in childhood. J Pediatr 1949; 34 (01) 62-69
• 2 Bacciedoni V, Attie M, Donato H. Comité Nacional de Hematología, Oncología y Medicina Transfusional Thrombosis in newborn infants. Arch Argent Pediatr 2016; 114 (02) 159-166
• 3 Paes BA, Nagel K, Sunak I, Rashish G, Chan AK. ; Thrombosis and Hemostasis in Newborns (THiN) Group. Neonatal and infant pulmonary thromboembolism: a literature review. Blood Coagul Fibrinolysis 2012; 23 (07) 653-662
• 4 Sawyer T, Antle A, Studer M, Thompson M, Perry S, Mahnke CB. Neonatal pulmonary artery thrombosis presenting as persistent pulmonary hypertension of the newborn. Pediatr Cardiol 2009; 30 (04) 520-522
• 5 Roman K, Rosenthal E, Razavi R. Pulmonary arterial thrombosis in a neonate with homozygous deficiency of antithrombin III: successful outcome following pulmonary thrombectomy and infusions of antithrombin III concentrate. Cardiol Young 2000; 10 (03) 275-278
• 6 Nicholson GT, Kogon B, Vincent R. AngioJet rheolytic thrombectomy in a neonate with pulmonary artery thrombus. Catheter Cardiovasc Interv 2013; 82 (05) E704-E707
• 7 van Schendel MP, Visser DH, Rammeloo LA, Hazekamp MG, Hruda J. Left pulmonary artery thrombosis in a neonate with left lung hypoplasia. Case Rep Pediatr 2012; 2012: 314256
• 8 Rauch R, Kaulitz R, Hofbeck M. Title page. Pulmonary artery thrombosis in a premature infant. Ultraschall Med 2008; 29 (03) 233-234
• 9 DeMeo SD, Sherwood A, Hornik CD, Goldberg RN, Cotten CM, Bidegain M. Pulmonary artery thrombus in a premature neonate treated with recombinant tissue plasminogen activator. J Perinatol 2014; 34 (07) 569-571
• 10 Morales JP, Sabharwal T, Tibby SM, Burnand KG. Successful thrombolysis of a symptomatic neonatal aortic thrombosis associated with hypernatraemic dehydration--case report and literature review. Int J Clin Pract 2008; 62 (03) 502-505
• 11 Iglesias Fernández C, Chimenti Camacho P, Vázquez López P, Guerrero Soler M, Blanco Bravo D. Aortic and cerebral thrombosis caused by hypernatremic dehydration in an exclusively breast-fed infant [Spanish]. An Pediatr (Barc) 2006; 65 (04) 381-383
• 12 Remy-Jardin M, Pistolesi M, Goodman LR. , et al. Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner Society. Radiology 2007; 245 (02) 315-329
• 13 Rajpurkar M, Biss T, Amankwah EK. , et al. Pulmonary embolism and in situ pulmonary artery thrombosis in paediatrics. A systematic review. Thromb Haemost 2017; 117 (06) 1199-1207
• 14 Lilje C, Chauhan A, Turner JP. , et al. Pediatric pulmonary embolism: diagnostic and management challenges. World J Pediatr Congenit Heart Surg 2016;
• 15 Miyakis S, Lockshin MD, Atsumi T. , et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4 (02) 295-306