The authors present an infant with left ventricular and mitral valve thrombi diagnosed by cross-sectional echocardiography. Thrombosis was due to acquired transient protein C deficiency, which was caused by impaired liver function due to sepsis. Because the thombi were very large and mobile, urgent surgery was performed. Eight weeks later, the patient's protein C level returned to normal ranges. The authors suggest that in all cases with intracardiac thrombosis, protein C deficiency should be investigated.
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References
1.
Clouse LH, Comp PC: The regulation of hemostasis: The protein C system. N Engl J Med, 314:1298-1304, 1986.
2.
Manco-Johnson MJ, Marlar RA, Jacobson LJ, et al: Severe protein C deficiency in newborn infants. J Pediatr113:359-363, 1988.
3.
Seligsohn U. , Berger A., Abend M., et al: Homozygous protein C deficiency manifested by massive venous thrombosis in the newborn. N Engl J Med , 310:559-563, 1984.
4.
Marlar RA, Montgomery RR, Broekmans AW, and the Working Party. Diagnosis and treatment of homozygous protein C deficiency. Report of the Working Party on homozygous protein C deficiency of the subcommittee on protein S, International Committee onThrombosis and Haemostasis. J Pediatr114:528-534, 1989.
5.
Özkutlu S., Ozbarlas N., Saraçlar M., et al: Left ventricular thrombosis due to acquired protein C deficiency diagnosed by two-dimensional echocardiography. Jpn Heart J33:253-257, 1992.
6.
Vinazzer H., Pangraz U.: Protein C: Comparison of different assays in normal and abnormal plasma samples . Thromb Res46:1-7, 1987.
7.
Felner JM, Churchwell AL, Murphy DA: Right atrial thromboemboli: Clinical, echocardiographic, and pathophysiological manifestations. J Am Coll Cardiol4:1041-1051, 1982.
8.
Kàdàr K., Kiràly HL, Bendig L.: Right heart thrombus in infants and children. Pediatr Cardiol12:24-27, 1991.
9.
Kupherschmidt C., Schmaltz AA, Tacke E., et al: Left ventricular thrombi in three children with dilated cardiomyopathy: Diagnostic procedure and clinical course . Pediatr Cardiol5:65-70, 1984.
10.
Sharratt GP , Lacson AG, Cornel G., et al: Echocardiography of intracardiac filling defects in infants and children. Pediatr Cardiol7:189-194, 1986.
11.
Okutlu S., Saraçlar M., Atalay S., et al: Two-dimensional echocardiographic diagnosis of tricuspid valve noninfective endocarditis due to protein C deficiency. Jpn Heart J32:139-145, 1991.
12.
Gremse DA, Peevy KJ, Walkerspiel JN, et al: Aortic thrombosis in a neonate with undetectable protein C. Pediatr Radiol20:198-199, 1990.
13.
MacDonald PD , Walker ID, Galez P., et al: Acquired transient protein C deficiency in neonatal cardiac failure. Arch Dis Child65:158, 1990.
