A newborn with a massive subgaleal haematoma and a rare haematological diagnosis

Congenital factor xiii deficiency is an extremely rare bleeding disorder, which is inherited in an autosomal recessive pattern.^1,5 Factor xiii is the key element in the terminal end of the coagulation cascade that ensures the stability of blood clot formation.¹ Delayed bleeding (12 to 36 hours) after trauma or surgery is the pathognomonic feature of factor xiii deficiency.² Here, we report on a term neonate with congenital factor xiii deficiency, who was diagnosed following significant delayed bleeding tendencies in the form of subgaleal haemorrhage and subcutaneous bleeding on the dorsum of the left hand, severe enough to drop the haemoglobin drastically to 62g/L, requiring urgent blood transfusion.

Dr S.P.N. Weerasekara
Speciality Doctor, Department of Paediatrics, Lincoln County Hospital

Dr Udoka Asoh
Paediatric Consultant, Lincoln County Hospital
udoka.asoh@ulh.nhs.uk

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Keywords

congenital factor xiii deficiency; computerised tomography; cerebral function monitoring; subgaleal haematoma

Key points

Subgaleal haematoma usually does not require neurosurgical intervention.
Factor xiii is also known as fibrin stabilising factor.
Factor xiii deficiency is a rare, autosomal recessive inherited bleeding disorder.

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VOLUME 19 ISSUE 4/JULY 2023

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