Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case Report

Background: Kasabach–Merritt phenomenon (KMP) is a rare condition characterized by thrombocytopenia and consumptive coagulopathy in the setting of rapidly expanding vascular tumors. Association with congenital hydrocephalus has not been reported. Clinical Description: A one-and-a-half-month-old fema...

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Main Authors: Kritika Goel, Tanu Jhajhria, Hema Gupta Mittal, Bijoy Patra
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Indian Pediatrics Case Reports
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Online Access:https://journals.lww.com/10.4103/ipcares.ipcares_226_24
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author Kritika Goel
Tanu Jhajhria
Hema Gupta Mittal
Bijoy Patra
author_facet Kritika Goel
Tanu Jhajhria
Hema Gupta Mittal
Bijoy Patra
author_sort Kritika Goel
collection DOAJ
description Background: Kasabach–Merritt phenomenon (KMP) is a rare condition characterized by thrombocytopenia and consumptive coagulopathy in the setting of rapidly expanding vascular tumors. Association with congenital hydrocephalus has not been reported. Clinical Description: A one-and-a-half-month-old female infant presented with fever and progressively enlarging head size. Examination showed macrocephaly, bulging fontanelle, pallor and a large, irregular, firm, nontender lesion extending from the nape of the neck to the right scapular region with overlying reddish discoloration. Systemic examination was normal. Management and Outcome: Investigations showed thrombocytopenia, though the septic screen was otherwise negative. Calcium levels and cerebrospinal evaluation were normal. The prothrombin time (PT), activated partial thromboplastin time and international normalized ratio were normal, but fibrinogen was low, and D-dimer was raised. Brain imaging showed communicating hydrocephalus. Ultrasound and magnetic resonance angiography were consistent with Kaposiform hemangioendothelioma (KHE). A final diagnosis of KMP with KHE associated with hydrocephalus was made. The infant was successfully treated with platelet transfusions along with pulse steroids and vincristine and referred for neurosurgery. Conclusion: This case is perhaps the first describing an association of congenital hydrocephalus with KMP and KHE. Specific therapy for vascular tumor resulted in regression of the manifestations of KMP.
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publishDate 2025-04-01
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spelling doaj-art-ce3008d98fd1478d964acd0dbdacc5ae2025-08-20T02:02:16ZengWolters Kluwer Medknow PublicationsIndian Pediatrics Case Reports2772-51702772-51892025-04-015210010410.4103/ipcares.ipcares_226_24Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case ReportKritika GoelTanu JhajhriaHema Gupta MittalBijoy PatraBackground: Kasabach–Merritt phenomenon (KMP) is a rare condition characterized by thrombocytopenia and consumptive coagulopathy in the setting of rapidly expanding vascular tumors. Association with congenital hydrocephalus has not been reported. Clinical Description: A one-and-a-half-month-old female infant presented with fever and progressively enlarging head size. Examination showed macrocephaly, bulging fontanelle, pallor and a large, irregular, firm, nontender lesion extending from the nape of the neck to the right scapular region with overlying reddish discoloration. Systemic examination was normal. Management and Outcome: Investigations showed thrombocytopenia, though the septic screen was otherwise negative. Calcium levels and cerebrospinal evaluation were normal. The prothrombin time (PT), activated partial thromboplastin time and international normalized ratio were normal, but fibrinogen was low, and D-dimer was raised. Brain imaging showed communicating hydrocephalus. Ultrasound and magnetic resonance angiography were consistent with Kaposiform hemangioendothelioma (KHE). A final diagnosis of KMP with KHE associated with hydrocephalus was made. The infant was successfully treated with platelet transfusions along with pulse steroids and vincristine and referred for neurosurgery. Conclusion: This case is perhaps the first describing an association of congenital hydrocephalus with KMP and KHE. Specific therapy for vascular tumor resulted in regression of the manifestations of KMP.https://journals.lww.com/10.4103/ipcares.ipcares_226_24consumption coagulopathyhemangiomakaposiform hemangioendotheliomathrombocytopenia
spellingShingle Kritika Goel
Tanu Jhajhria
Hema Gupta Mittal
Bijoy Patra
Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case Report
Indian Pediatrics Case Reports
consumption coagulopathy
hemangioma
kaposiform hemangioendothelioma
thrombocytopenia
title Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case Report
title_full Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case Report
title_fullStr Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case Report
title_full_unstemmed Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case Report
title_short Kasabach–Merritt Phenomenon Associated with Congenital Hydrocephalus: A Case Report
title_sort kasabach merritt phenomenon associated with congenital hydrocephalus a case report
topic consumption coagulopathy
hemangioma
kaposiform hemangioendothelioma
thrombocytopenia
url https://journals.lww.com/10.4103/ipcares.ipcares_226_24
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AT tanujhajhria kasabachmerrittphenomenonassociatedwithcongenitalhydrocephalusacasereport
AT hemaguptamittal kasabachmerrittphenomenonassociatedwithcongenitalhydrocephalusacasereport
AT bijoypatra kasabachmerrittphenomenonassociatedwithcongenitalhydrocephalusacasereport