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Giant hemangioma with thrombocytopenia and osteolysis successfully treated with prednisone

N Sadan1, I Horowitz, L Choc

  • 1Department of Pediatrics, Meir General Hospital, Sapir Medical Center, Kfar Saba, Israel.

Insights

A rare case of Kasabach-Merritt syndrome in an infant, characterized by hemangioma, thrombocytopenia, and bone destruction, was successfully treated with prednisone. The treatment led to cessation of bleeding and significant bone reconstruction, with normal pelvic films by age three.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Pediatric Surgery

Background:

  • Kasabaka-Merritt syndrome is a rare condition characterized by hemangioma, thrombocytopenia, and coagulopathy.
  • Complete osteolysis associated with Kasabaka-Merritt syndrome is exceptionally rare.
  • This case highlights a unique presentation with significant bone destruction.

Observation:

  • A 6-week-old infant presented with a hemangioma, severe thrombocytopenia, consumption coagulopathy, extensive bleeding, and destruction of the right pubic and iliac bones.
  • The patient experienced life-threatening bleeding and substantial bone loss.
  • Radiographic evidence showed complete disappearance of the right pubic bone and partial destruction of the right iliac bone.

Findings:

  • Successful treatment with prednisone over 30 weeks.
  • Bleeding resolved within days of initiating prednisone therapy.
  • Bone rebuilding was observed starting at 30 days and was extensive by the end of treatment.
  • Pelvic radiographs were normal by age 3 years.

Implications:

  • Prednisone can be an effective treatment for Kasabaka-Merritt syndrome with associated osteolysis.
  • This case demonstrates the potential for significant bone reconstruction following successful treatment.
  • Highlights the importance of early diagnosis and intervention for this rare syndrome.

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