A newborn with moderate hemophilia A with severe intracranial and extracranial hemorrhage: A case report

Headnote

Received : 27.12.2016 ; Revised: 10.04.2017 ; Accepted : 27.07.2017

Abstract

Intracranial hemorrhage among term newborns is a rare clinical condition with high morbidity and mortality. Although major bleeding is relatively uncommon, the incidence of intracranial hemorrhage in hemophilic children is higher during the first few days of life than at any other stage in childhood, which relates to the trauma of delivery. Here, we reported a newborn case diagnosed with moderate hemophilia A, without the presence of a positive family history of hemophilia and presenting with intracranial and extracranial hemorrhage and we aimed to emphasize that the early diagnosis and replacement therapy carries an essential importance.

Keywords: newborn, hemophilia A, intracranial hemorrhage, extracranial hemorrhage.

Özet

İntrakranial kanamalar term yenidoğanlarda nadir görülen, morbiditě ve mortalitesi yüksek bir klinik tablodur. Majör kanamalar nispeten nadir olmasına rağmen, hemofilik çocuklarda yaşamın ilk birkaç gününde doğum travmasına bağlı gelişebilecek intrakranial kanama insidansı, çocukluğun herhangi bir evresine göre daha yüksektir.

Burada, ailesinde hemofili öyküsü bulunmayan, intrakranial ve ekstrakranial hemoraji ile başvurup orta derecede hemofili A tanısı konan bir yenidoğan olgusunu sunmayı ve erken teşhis ve replasman tedavisinin hayati bir öneme sahip olduğunu vurgulamayı amaçladık.

Anahtar kelimeler: Yenidoğan, hemofili A, intrakranial hemoraji, ekstrakranial hemoraji

INTRODUCTION

Hemophilia is one of the common hereditary bleeding disorder that may lead to severe lifethreatening bleeding. Most hemophilic patients experience no problem during the neonatal period, but bleeding including intracranial hemorrhage leading to severe mortality and morbidity may rarely be observed during this period. Early diagnosis is very important in terms of prognosis in these cases. However, the diagnosis is usually delayed due to confusion of clinical signs of intracranial bleeding with other conditions in the newborn period, absence of family history in 30% of cases and the lack of information about the mother is a carrier of hemophilia1.

In this case report, we presented a newborn diagnosed with extracranial hemorrhage (ECH) on the first postnatal day was then referred to our tertiary neonatal intensive care unit on the 7th day of life in an intubated status because of respiratory arrest due to intracranial hemorrhage (ICH) and was diagnosed with moderate hemophilia A with no familial history. We aimed to emphasize the fact that moderate hemophilia could also rarely lead to intracranial hemorrhage in term...