Abstract
BackgroundFetal thrombotic vasculopathy is a described placental diagnosis associated with adverse perinatal outcomes. It may also predispose children to somatic thromboembolic events. As far as we know, this is the first case of inferior vena cava thrombosis associated with fetal thrombotic vasculopathy in a completely asymptomatic newborn.Case presentationWe report the case of an asymptomatic, full-term Turkish male neonate delivered at 39 weeks of gestation diagnosed as having thrombosis of the renal vein and inferior vena cava. Diagnosis was guided only by the presence of edematous umbilical cord with macroscopic signs of clotting and, subsequently, microscopic features of the placenta, suggesting fetal thrombotic vasculopathy.ConclusionsThrombosis of the renal and inferior vena cava in our healthy, asymptomatic full-term neonate is clearly associated with fetal thrombotic vasculopathy. The diagnosis of thrombosis in this neonate was incidental. This suggests that fetal thrombotic vasculopathy may cause unrecognized neonatal thrombosis. Untreated neonatal thrombosis may later compromise growth and function of the involved organs; therefore, maintaining a high index of suspicion based on thrombotic vasculopathy is paramount.
Highlights
Fetal thrombotic vasculopathy is a described placental diagnosis associated with adverse perinatal outcomes
Thrombosis of the renal and inferior vena cava in our healthy, asymptomatic full-term neonate is clearly associated with fetal thrombotic vasculopathy
The diagnosis of thrombosis in this neonate was incidental. This suggests that fetal thrombotic vasculopathy may cause unrecognized neonatal thrombosis
Summary
Our case report stresses two important considerations. First, thrombosis of the renal vein and IVC in our healthy asymptomatic term neonate is clearly associated with FTV. FTV should be included among the reported causes of renal vein thrombosis in neonates. 2. Wintermark P, Boyd T, Parast MM, Van Marter LJ, Warfield SK, Robertson RL, Ringer SA. Fetal thrombotic vasculopathy is associated with thromboembolic events and adverse perinatal outcome but not with neurologic complications: a retrospective cohort study of 54 cases with a 3-year follow-up of children. Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Obstetric and perinatal complications in placentas with fetal thrombotic vasculopathy. Redline RW, Ariel I, Baergen RN, Desa DJ, Kraus FT, Roberts DJ, Sander CM. Author details 1Department of Pediatrics, Regional Hospital of Lugano, Via Tesserete 46, 6900 Lugano, Switzerland. Author details 1Department of Pediatrics, Regional Hospital of Lugano, Via Tesserete 46, 6900 Lugano, Switzerland. 2Department of Pediatrics, University of Pavia, Pavia, Italy. 3Department of Radiology, Regional Hospital of Lugano, Lugano, Switzerland. 4Division of Hematology, University Children’s Hospital, Zurich, Switzerland
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