Purpura fulminans in a newborn infant with galactosemia

Abstract

An 11-day-old neonate presented with purpura fulminans and was subsequently diagnosed with galactosemia. Neonatal purpura fulminans occurs predominantly in patients suffering from inherited protein C deficiency or disseminated intravascular coagulation associated with septicemia. Hemostatic changes in patients with liver disease may result in bleeding or, rarely, thrombosis. We suppose that in the present patient, deficiency of protein C, secondary to liver disease, was responsible for the development of purpura fulminans. Treatment consisted of blood and blood products and galactose-free formula. The patient recovered with residual mild psychomotor retardation and the lesions with minimal scarring. In conclusion, galactosemia also should be kept in mind as an uncommon cause of purpura fulminans in newborn infants.

Antithrombotic Therapy in Neonates and Children

“…[420][421][422][423][424][425][426][427][428][429][430][431][432][433][434] Rarely have other causes been described. 435 The classic clinical presentation consists of cerebral or ophthalmic damage (or both) that occurred in utero. In up to 70% of cases, purpura fulminans occurs within hours or days of birth, and, on rare occasions, large-vessel thrombosis occurs .…”

Galactosemia a Disease that you Need to know

“…Galactosemia is a life-threatening disease for itself or for other complications like sepsis, so in countries like ours that do not have screening program for galactosemia, it should be investigated for the presence of clinical signs and symptoms. When there is no screening program, it is useful to find the presence of reducing substances in the urine [8,9,15,16,18] being able to demonstrate galactose in carbohydrate chromatography [16,18], with this finding galactose should be suspended from the diet; quantification of galactose and galactose 1P is required.…”

“…Polymerase chain reaction for cytomegalovirus showed 3381 copies, so he received hyperimmune immunoglobulin. [15,16] faint band that migrates to the height of galactose With suspected metabolic disease as a cause of liver failure, colorimetric tests were ordered in urine, see step1, step 2, step 3 (Figure 1). During his stay he required transfusion of deleukocyte packed red blood cells; after the interventions the patient slowly evolved towards improvement, recovered from liver failure and the new ophthalmology evaluation showed almost complete resolution of cataracts, leaving the institution at 2 months of age.…”

Galactosemia: Three Different Clinical Presentation: Case Report

“…Ülkemizden bildirilen olgu sunumlarında da hemofagositik lenfohistiyositoz, purpura fulminans, vitreus hemorajisi gibi klinik bulgular, altta yatan galaktozemi hastalığında kliniğin farklı şekillerde karşımıza çıkabileceğini göstermiştir. [21][22][23] Galaktozemi kliniğinde az rastlanan bulguların bilinmesi de hastalığın akla getirilebilmesini sağlar. Yenidoğan döneminde ölümle sonuçlanabilen, ancak erken tedaviyle önlenebilir bir hastalık olması nedeni ile galaktozemide erken tanı çok önemlidir.…”