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CC-BY-NC-ND 4.0 · AJP Rep 2017; 07(01): e13-e16
DOI: 10.1055/s-0037-1598044
Case Report
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Transient Hemi-Lower Limb Ischemia in the Newborn: Arterial Thrombosis or Persistent Sciatic Artery?

Makiko Kirino
1   Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Masayuki Ochiai
1   Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Masako Ichiyama
1   Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2   Department of Pediatrics, Fukuoka Children's Hospital and Medical Center, Fukuoka, Japan
,
Hirosuke Inoue
1   Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Takeshi Kusuda
1   Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
3   Department of Pediatrics, Faculty of Medicine and Health Sciences, Yamaguchi University, Ube, Japan
,
Tadamune Kinjo
1   Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
4   Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
,
Masataka Ishimura
1   Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Shouichi Ohga
3   Department of Pediatrics, Faculty of Medicine and Health Sciences, Yamaguchi University, Ube, Japan
5   Department of Perinatal and Pediatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
› Author Affiliations
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Publication History

11 July 2016

12 December 2016

Publication Date:
10 February 2017 (online)

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Abstract

Neonatal thromboembolism occurs with various predispositions and triggers. Early diagnosis of the thrombosis is challenging and essential for the therapeutic interventions. We herein report two newborns who presented with transient hemi-lower limb ischemia due to (1) arterial thrombosis or (2) a persistent sciatic artery (PSA). The patient with arterial thrombosis showed elevations of fibrin degradation product and D-dimer and received antithrombin and heparin intravenously. The patient with PSA was immediately assessed by a contrast-enhanced computed tomography because of a transient ischemic episode with no evidence of hypercoagulability. Newborns suspected of having arterial thrombosis may need urgent surgical intervention along with thrombolytic and anticoagulant therapy to prevent organ ischemia and amputation of extremities. Conversely, some PSA cases have reportedly been treated conservatively. This vascular anomaly was previously reported as a cause of lower limb ischemia only in a newborn. PSA is a critical differential diagnosis of neonatal arterial thrombosis that needs urgent therapeutic intervention.

Keywords

thromboembolism - vascular anomaly - heparin - antithrombin