イトウ　ナオコ   ITOU Naoko   井藤　奈央子    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Neonatal asphyxia and renal failure as the presentation of non-inherited protein C deficiency.
掲載誌名	正式名：Journal of perinatology : official journal of the California Perinatal Association 略　 称：J Perinatol ISSNコード：14765543/07438346
掲載区分	国外
巻・号・頁	33(3),pp.239-41
著者・共著者	Matsunaga Y, Ohga S, Kinjo T, Ochiai M, Ito N, Doi T, Kang D, Hara T
発行年月	2013/03
概要	Inherited or acquired protein C (PC) deficiency leads to thromboembolic events. Plasma PC activity in infancy is physiologically lower than in adults. We describe a case of neonatal asphyxia and acute renal failure associated with isolated PC deficiency. A full-term male infant was born to a healthy mother by caesarean section because of fetal distress. The small-for-gestational age infant showed 2 and 7 of Apgar scores at 1 and 5 minutes, respectively. Hypercoagulability required repeated infusions of fresh frozen plasma. Coagulation study revealed PC activity, 6%, protein S activity, 61%, and high D-dimer levels, along with normal factor VII activity and absent vitamin K deficiency. Anticoagulant and activated PC therapy improved coagulopathy and nephropathy. Imaging analyses indicated no visceral infarctions. Renal function and PC activity have been slowly normalized until 6 months of age. He had no PROC mutation or PC-deficient parents. Selective PC deficiency may occur as an acquired cause of hypercoagulable crisis in the stressed newborn.
DOI	10.1038/jp.2012.55
PMID	23443294