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Non‐catheter‐related aortic thrombosis and resistance to activated protein C in a premature newborn

Aortic thombosis in the newborn is usually associated with umbilical artery catheterization (1, 2). It may lead to death or such severe complications as intestinal necrosis, oliguria, renal hypertension, paraplegia and peripheral gangrene, depending on the size and localization of the thrombus. Immediate and efficient treatment is therefore required. Medical and surgical therapies have been attempted with varying results (1–13). Standardized therapeutic guidelines have not yet been established. We report on a premature newborn who developed spontaneous aortic thrombosis and was successfully treated with recombinant tissue plasminogen activator (rt-PA). The child was subsequently diagnosed as having activated protein C resistance (APCR) due to heterozygosity for the factor V R506Q mutation (factor V Leiden).