Factor VII deficiency presenting as a possible child abuse

Excerpt

A previously healthy 3 month old male presented to care following focal seizure activity involving the right side of the face. No history of trauma was reported. Magnetic resonance imaging (MRI) of the brain revealed a large left sided subdural hematoma with extension to the interhemispheric fissure (Fig. 1). Screening laboratory studies included a complete blood count (CBC), revealing anemia (hemoglobin 7.8, hematocrit 23; normal ranges 9–14 and 28–42 respectively), and prolonged coagulation studies, including a prothrombin time (PT) of 41.9 (normal range 10.8–14.7) and a partial thromboplastin time (PTT) of 42 (normal range 23–37). Results were confirmed on immediate repeat sampling. Dilated fundoscopic examination and a skeletal survey were normal. Physical examination revealed no cutaneous injuries.

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