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November 1997

Pathological Case of the Month

Author Affiliations

From the Department of Pediatrics, The Ohio State University, Columbus Children's Hospital, Columbus (Drs Long and Morrow); and the Department of Pathology, Saint Michael's Medical Center, Newark, NJ (Dr Pawel).

Arch Pediatr Adolesc Med. 1997;151(11):1165-1166. doi:10.1001/archpedi.1997.02170480095017

A 5-DAY-OLD white male infant was admitted to the hospital because of progressive cyanosis and coolness of one leg. He had a history of emesis and loose stools, but no fever, trauma, or abnormal birth history. Because of vomiting, the formula had been changed from a low-protein to a soy-protein formula prior to admission to the hospital.

Physical examination revealed hepatosplenomegaly and a cool, cyanotic right leg. During exploratory surgery, a thrombosis of the right common femoral artery was removed. A white blood cell count was 21.8×109/L, hematocrit 59.8, and platelet count 42×109/L. The child had disseminated intravascular coagulopathy, as noted by a prothrombin time of 33.1 seconds, partial thromboplastin time of more than 300 seconds, fibrinogen level of less than 0.1 g/L, and positive test results for fibrin degradation products.

Despite successful removal of the thrombus, disseminated intravascular coagulopathy continued that required fresh frozen plasma