BMJ Case Rep. 2019 Jul 3;12(7). pii: e227925. doi: 10.1136/bcr-2018-227925.
Respiratory failure secondary to congenital pulmonary arterial thrombus with lung dysplasia.
Odackal NJ1, McCulloch MA1, Hainstock MR1, Vergales BD1.
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Respiratory failure requiring extracorporeal membranous oxygenation in the newborn is commonly seen secondary to severe pathology such as congenital diaphragmatic hernia, meconium aspiration syndrome, pulmonary hypertension and pulmonary hypoplasia. However, atypical causes of respiratory failure, such as pulmonary arterial thrombi, are often refractory to traditional management and require careful multidisciplinary evaluation. We report a case of respiratory failure secondary to congenital pulmonary arterial thrombosis of unknown aetiology in an otherwise healthy neonate. We discuss the abnormal anatomy and pathophysiology that presented in our patient secondary to this condition and discuss our diagnostic process, management and outcomes. Additionally, we review the literature for reported cases and discuss current hypotheses on the development of congenital pulmonary arterial thrombi. Given the rare occurrence of this event, we hope to contribute to the understanding of future similar cases and emphasise the importance of keeping pulmonary arterial thrombi in the clinical differential.

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haematology (incl blood transfusion); neonatal intensive care

PMID: 31272991 DOI: 10.1136/bcr-2018-227925