Thrombotic events are being increasingly recognized during the neonatal period. An infant girl was born at 29 weeks' gestation after a pregnancy complicated by twin-to-twin transfusion syndrome. After an initial uncomplicated clinical course, her oxygen requirement increased, which was interpreted as an early sign of bronchopulmonary dysplasia. At 3 weeks of age, she suddenly collapsed and died of severe pulmonary hypertension. At autopsy, multiple pulmonary artery emboli and several older renal vein thromboses were found. Results of genetic analyses of the infant and her family were negative for thrombophilia. Although embolism represents a frequent emergency in adults, fatal pulmonary embolism has never, to our knowledge, been described for premature infants. This case suggests that thrombotic events are underdiagnosed and that additional studies are needed to define infants at risk and optimal treatment strategies.
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August 2010
Case Reports|
August 01 2010
Fatal Pulmonary Embolism in a Premature Neonate After Twin-to-Twin Transfusion Syndrome
Luregn Jan Schlapbach, MD;
Departments of aPediatrics and
Address correspondence to Luregn Jan Schlapbach, MD, Department of Pediatrics, Inselspital, University of Bern, 3010 Bern, Switzerland. E-mail: luregn.schlapbach@insel.ch
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Thomas Riedel, MD;
Thomas Riedel, MD
Departments of aPediatrics and
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Vera Genitsch, MD;
Vera Genitsch, MD
bPathology, University of Berne, Berne, Switzerland
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Mathias Nelle, MD;
Mathias Nelle, MD
Departments of aPediatrics and
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Felicity Jane McDougall, MD
Felicity Jane McDougall, MD
Departments of aPediatrics and
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Address correspondence to Luregn Jan Schlapbach, MD, Department of Pediatrics, Inselspital, University of Bern, 3010 Bern, Switzerland. E-mail: luregn.schlapbach@insel.ch
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2010) 126 (2): e483–e487.
Article history
Accepted:
April 26 2010
Citation
Luregn Jan Schlapbach, Thomas Riedel, Vera Genitsch, Mathias Nelle, Felicity Jane McDougall; Fatal Pulmonary Embolism in a Premature Neonate After Twin-to-Twin Transfusion Syndrome. Pediatrics August 2010; 126 (2): e483–e487. 10.1542/peds.2009-3490
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