Acquired prothrombin complex deficiency with hydrocephalus in a 43-day-old infant: A case report

Abstract

Background: Acquired prothrombin complex deficiency (APCD) is a spontaneous bleeding disorder caused by decreased activity of vitamin K-dependent coagulation factors that can be found in newborns up to six months of age. We would like to report a case of APCD with intracranial hemorrhage and its complication that have been found in Dr. Soetomo General Hospital, Surabaya, Indonesia. This study aimed to identify complications that can be found in patients with APCD.

Case presentation: A 43-day-old child came to the hospital with a chief complaint of fever 11 days before with a history of a general seizure lasting more than 15 minutes. The patient experienced bleeding in the injection site and got the treatment injection of vitamin K and a fresh frozen plasma (FFP) transfusion as the initial treatment of APCD. The physical examination showed the baby was compos mentis with a Glasgow Coma Scale (GCS) of 15 (E4V5M6). Laboratory examination showed hemoglobin levels of 8.7g/dL, prothrombin time (PT) of 13 seconds, activated partial thromboplastin time (APTT) was extended by 112 seconds, and platelet showed a normal value of 279 x 10^3µL. Head computed tomography (CT) scan examination showed bleeding and hydrocephalus. The patient was treated with non-operative and operative management.

Conclusion: Patients with APCD should be treated not only with non-surgical treatment but also with surgical treatment also.