井藤　奈央子    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Assistant Professor
Article types	Case report
Language	English
Peer review	Peer reviewed
Title	Neonatal asphyxia and renal failure as the presentation of non-inherited protein C deficiency.
Journal	Formal name：Journal of perinatology : official journal of the California Perinatal Association Abbreviation：J Perinatol ISSN code：14765543/07438346
Domestic / Foregin	Foregin
Volume, Issue, Page	33(3),pp.239-41
Author and coauthor	Matsunaga Y, Ohga S, Kinjo T, Ochiai M, Ito N, Doi T, Kang D, Hara T
Publication date	2013/03
Summary	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