A 4½-week-old boy had acute onset of respiratory distress and anemia. A chest roentgenogram demonstrated a large anterior mediastinal mass. Laboratory studies and clinical course were consistent with nonconsumptive coagulopathy and acute blood loss. The coagulopathy was responsive to fresh frozen plasma and vitamin-K therapy. Thoracotomy disclosed an enlarged, hemorrhagic thymus, which was excised. This entirely relieved the respiratory distress. Microscopical examination showed hemorrhage into an otherwise normal thymus, a previously unreported phenomenon, to the authors' knowledge. The possible cause of the hemorrhage was late-onset hemorrhagic disease of the newborn.
Sieger L, Higgins GR, Van Adelsberg S, Isaacs H. Acute Thymic Hemorrhage: An Unusual Cause of Respiratory Distress in Infancy. Am J Dis Child. 1974;128(1):86–87. doi:10.1001/archpedi.1974.02110260088017
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