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Case report
Congenital protein C deficiency causing major arterial thrombosis in a neonate
  1. Sanchari Chakravarty,
  2. Saugata Acharyya and
  3. Manas Kumar Mahapatra
  1. Pediatrics, Calcutta Medical Research Institute, Kolkata, West Bengal, India
  1. Correspondence to Dr Sanchari Chakravarty, sanchari.chakravarty{at}


A 9-day-old female baby presented with complaints of progressively worsening respiratory distress and lethargy. The parents were first cousins with history of multiple fetal losses in previous pregnancies. On examination, the baby was noted to be tachypnoeic, tachycardic with poor peripheral perfusion of the lower extremities. Femoral pulses on both sides were barely palpable. Echocardiography was normal. But cardiac catheterisation revealed the presence of an intraluminal obstruction of the distal aorta by a large thrombus. An attempt to dissolve the thrombus with urokinase infusion was unsuccessful. The affected vessels were then surgically explored and a large thrombus from the common iliac artery and distal abdominal aorta was removed. Following this, the child recovered uneventfully with return of lower limb pulsation. A thrombotic profile revealed the underlying diagnosis of congenital protein C deficiency responsible for the arterial thrombosis. This is an extremely unusual presentation, hardly ever been reported before.

  • neonatal and paediatric intensive care
  • haematology (incl blood transfusion)
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  • Contributors All three authors were involved in the clinical management of the patient. The patient was admitted under SA. The manuscript was conceptualised by SA. All authors were involved in the planning. The literature review was done by SC. The write-up was prepared by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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