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  • Perinatal/Neonatal Case Presentation
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Perinatal/Neonatal Case Presentation

Neonatal asphyxia and renal failure as the presentation of non-inherited protein C deficiency

Journal of Perinatology volume 33, pages 239–241 (2013)Cite this article

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Abstract

Inherited or acquired protein C (PC) deficiency leads to thromboembolic events. Plasma PC activity in infancy is physiologically lower than in adults. We describe a case of neonatal asphyxia and acute renal failure associated with isolated PC deficiency. A full-term male infant was born to a healthy mother by caesarean section because of fetal distress. The small-for-gestational age infant showed 2 and 7 of Apgar scores at 1 and 5 minutes, respectively. Hypercoagulability required repeated infusions of fresh frozen plasma. Coagulation study revealed PC activity, 6%, protein S activity, 61%, and high D-dimer levels, along with normal factor VII activity and absent vitamin K deficiency. Anticoagulant and activated PC therapy improved coagulopathy and nephropathy. Imaging analyses indicated no visceral infarctions. Renal function and PC activity have been slowly normalized until 6 months of age. He had no PROC mutation or PC-deficient parents. Selective PC deficiency may occur as an acquired cause of hypercoagulable crisis in the stressed newborn.

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Authors and Affiliations

  1. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Y Matsunaga, S Ohga, T Kinjo, M Ochiai, N Ito, T Doi & T Hara

  2. Department of Perinatal and Pediatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    S Ohga

  3. Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan

    D Kang

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  1. Y Matsunaga
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  2. S Ohga
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  3. T Kinjo
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  4. M Ochiai
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  7. D Kang
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  8. T Hara
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Correspondence to S Ohga.

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Matsunaga, Y., Ohga, S., Kinjo, T. et al. Neonatal asphyxia and renal failure as the presentation of non-inherited protein C deficiency. J Perinatol 33, 239–241 (2013). https://doi.org/10.1038/jp.2012.55

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  • DOI: https://doi.org/10.1038/jp.2012.55

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