Dehydration as a Rare Cause of Pulmonary Artery Thrombosis in a 2-Week-Old Term Neonate

Abstract

Pulmonary arterial thrombosis is an extremely rare occurrence in the neonatal population. We describe a 2-week-old female neonate who presented in critical condition with severe cyanosis and dehydration and was found to have a large thrombus in the main branches of the pulmonary arteries. She was successfully treated with surgical embolectomy. Pulmonary arterial thrombosis should always be considered in the differential diagnosis of a dehydrated neonate presenting with severe cyanosis and evidence of pulmonary hypertension.

Spontaneous neonatal pulmonary arterial thrombosis – cases, mechanisms, and literature review

“…5 Our systematic review identified 20 reported cases of pulmonary artery thrombi in neonates, with a general review provided in Table 1. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Aetiologies varied but can be broadly categorised into those with intrinsic and extrinsic predisposing factors. Intrinsic issues include anatomic anomalies and thrombotic disorders, while extrinsic issues largely comprised either a serious infection, maternal conditions that predispose to neonatal thrombosis (e.g., diabetes mellitus), or perinatal asphyxia with severe stress.…”

“…Medical management with anticoagulants may be reasonable for patients with mild symptoms requiring minimal treatments (e.g., nasal cannula oxygen), while systemic tissue plasminogen activator, transcatheter angioplasty, surgical thrombectomy, and even extracorporeal membrane oxygenation may be indicated for more ill patients with larger occlusive/near-occlusive thrombi or evidence of right ventricle strain. 10,15,17…”

Pulmonary Artery Thrombosis in a Newborn With Severe Coronavirus Disease 2019

“…PA thrombosis is rare in newborns. 1 Although a predisposing thrombophilic condition could not be ruled out due to the patient’s age and that severe dehydration might have contributed, 1 we suspect that COVID-19-associated coagulopathy (CAC) might have played a key role.…”