Case Report of a Massive Life-threatening Neonatal Thrombosis Treated With a Targeted, Goal-oriented Scheme of Urokinase

J Pediatr Hematol Oncol. 2022 Oct 1;44(7):405-408. doi: 10.1097/MPH.0000000000002410. Epub 2022 Feb 4.

Abstract

Background: Thrombotic events are severe, often under-diagnosed, complications occurring in newborn infants during their hospital stay. Currently, there is no consensus regarding the optimal treatment scheme for thrombolysis in neonates.

Observations: We present the case of a newborn suffering from a life-threatening thrombosis. Diagnosis was suggested by a gradual increase of C-reactive protein, with repeatedly normal procalcitonin. Thrombosis was successfully and safely treated with a long scheme of 21 days of urokinase, supported by vascular ultrasound and d-dimer trend.

Conclusions: Laboratory and ultrasound results may help in adjusting the duration of the thrombolytic treatment, allowing for longer therapeutic schemes that could optimize treatment success. In addition, our case may suggest a possible combined role of C-reactive protein and procalcitonin as an early diagnostic aid in neonatal thrombosis.

Publication types

  • Case Reports

MeSH terms

  • C-Reactive Protein
  • Goals
  • Humans
  • Infant
  • Infant, Newborn
  • Procalcitonin
  • Thrombolytic Therapy / methods
  • Thrombosis* / etiology
  • Urokinase-Type Plasminogen Activator* / therapeutic use

Substances

  • Procalcitonin
  • C-Reactive Protein
  • Urokinase-Type Plasminogen Activator