Phenocopy of warfarin syndrome in an infant born to a mother with sickle cell anemia and severe transfusional iron overload.

Abstract

Neonatal chondrodysplasia punctata (CDP) is characterized by epiphyseal stippling and midfacial hypoplasia. CDP is usually inherited, but can be acquired because of maternal vitamin K deficiency. We describe an infant with CDP born to a teenager with sickle cell anemia and transfusional iron overload. The mother had severe liver fibrosis, elevated liver iron concentration (34 mg Fe/g), and coagulopathy, but no gestational use of warfarin. Fetal abnormalities were attributed to vitamin K deficiency secondary to liver dysfunction from iron toxicity. Treatment of iron overload among women with sickle cell anemia of childbearing potential is important to avoid possible CDP in newborns.

• Authors: Yi Xie, Eniko K Pivnick, Harris L Cohen, Patricia E Adams-Graves, Massroor Pourcyrous, Banu Aygun, Jane S Hankins
• Journal: Journal of pediatric hematology/oncology (J Pediatr Hematol Oncol) Vol. 35 Issue 6 Pg. e265-8 (Aug 2013) ISSN: 1536-3678 [Electronic] United States
• PMID: 23018567 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Warfarin

Topics

• Abnormalities, Drug-Induced
• Adolescent
• Anemia, Sickle Cell (therapy)
• Chondrodysplasia Punctata (congenital, etiology)
• Female
• Humans
• Infant, Newborn
• Iron Overload (complications)
• Liver Diseases (etiology)
• Male
• Nasal Bone (abnormalities)
• Pregnancy
• Pregnancy Complications (etiology, pathology)
• Transfusion Reaction
• Vitamin K Deficiency (complications)
• Warfarin (adverse effects)