A neonatal case of hemophilia A diagnosed on the basis of intractable subgaleal hematoma

Abstract

Hemophilia is characterized by suggillation or hematoma after 6 months of age and it rarely causes bleeding symptoms in the neonatal period. We report our experience of treating a male neonate with hemophilia A complicated by subgaleal hematoma and disseminated intravascular coagulation (DIC). The patient was born through vaginal delivery and had a subgaleal hematoma. He was subsequently transferred to us and was diagnosed as having DIC: concentrated erythrocytes and fresh frozen plasma were successfully administered. However, three days after administration, it was observed that his hematoma exacerbated, and the activated partial thromboplastin time (APTT) was extraordinarily prolonged. These findings prompted us to measure his plasma coagulation factor VIII activity. As a result, a decreased activity was found, which led to a diagnosis of severe hemophilia A. Although neonatal subgaleal hematoma is relatively common, we should have a high index of suspicion for hemophilia when a patient shows intractable courses or extraordinarily prolonged APTT.