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Acquired Versus Congenital Neonatal Purpura Fulminans

A Case Report and Literature Review

Findley, Tina, MD*; Patel, Minal, MD*; Chapman, John, MD*; Brown, Deborah, MD; Duncan, Andrea F., MD, MSClinRes*

Journal of Pediatric Hematology/Oncology: November 2018 - Volume 40 - Issue 8 - p 625–627
doi: 10.1097/MPH.0000000000001150
Clinical and Laboratory Observations

Neonatal purpura fulminans (PF) is a life-threatening disorder caused by congenital or acquired deficiencies of protein C (PC) or S. PF presents as a cutaneous manifestation of disseminated intravascular coagulation. We describe a case of PF in a newborn with left leg ischemia and undetectable PC levels soon after birth. Despite anticoagulation therapy and PC concentrate, left foot amputation was required. Genetic testing of PROC for congenital PC deficiency was normal. This case highlights the course of PF due to acquired PC deficiency in a newborn treated with PC concentrate which is rarely described in the literature.

*Department of Pediatrics, Division of Neonatal-Perinatal Medicine

Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Texas at Houston McGovern Medical School, Houston, TX

The authors declare no conflict of interest.

Reprints: Andrea F. Duncan, MD, MSClinRes, Department of Pediatrics, Division of Neonatal-Perinatal Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 3.254, Houston, TX 77030 (e-mail:

Received May 11, 2017

Accepted February 5, 2018

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