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Case Reports: Reminder of important clinical lesson
Delayed and prolonged umbilical stump bleeding in a Caucasian newborn as a presenting feature of factor XIII deficiency
  1. David Boon Ngan Lim1,
  2. Sarah Mangles2 and
  3. Aruna Goturu1
  1. 1Paediatrics, Frimley Health NHS Foundation Trust, Camberley, UK
  2. 2Haematology, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, UK
  1. Correspondence to Dr David Boon Ngan Lim; davidlimbn{at}gmail.com

Abstract

A term Caucasian neonate with an uncomplicated birth history presented with persistent umbilical stump bleeding unresponsive to extensive topical haemostatic measures initially. He subsequently developed hypovolaemic shock. Routine full blood count and basic coagulation screen were unremarkable. He received packed red cell and cryoprecipitate transfusions. Further specialist coagulation studies performed revealed factor XIII deficiency. Genetic investigations demonstrated a compound heterozygosity for the disorder. He was later started on monthly prophylactic treatment of plasma-derived factor XIII. Clinicians should have a high index of suspicion for factor XIII deficiency for newborns with abnormal umbilical stump bleeding in the presence of no bleeding risk factors and normal routine blood investigations.

  • haematology (incl blood transfusion)
  • paediatrics
  • congenital disorders
  • neonatal health

https://doi.org/10.1136/bcr-2022-248743

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    Footnotes

    • Contributors DBNL drafted the manuscript. AG and SM edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.