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A deep-tissue hemangioma presenting as a rapidly progressive expanding mass and thrombocytopenia in an infant
1University of Tennessee Medical School, Department of Emergency Medicine, Le Bonheur Children's Medical Center, Memphis, USA.
Insights
Kasabach-Merritt syndrome, a rare complication of childhood hemangiomas, presents diagnostic challenges in the emergency department. Prompt identification and management are crucial for affected children.
Area of Science:
- Pediatric Emergency Medicine
- Dermatology
- Hematology
Background:
- Childhood hemangiomas are common, but Kasabach-Merritt syndrome is a rare, life-threatening complication.
- Emergency physicians must be prepared to diagnose and manage diverse pediatric emergencies, including rare conditions.
Observation:
- A case of Kasabach-Merritt syndrome presenting as a mass in a pediatric emergency department is described.
- The patient presented with thrombocytopenia and microangiopathic hemolysis secondary to a hemangioma.
Findings:
- Kasabach-Merritt syndrome requires prompt diagnosis and intervention to prevent severe complications.
- Methylprednisolone therapy was initiated, and the patient was referred to hematology.
Implications:
- This case highlights the importance of maintaining a broad differential diagnosis for pediatric masses in the emergency setting.
- Emergency physicians play a critical role in the early recognition and management of rare pediatric conditions like Kasabach-Merritt syndrome.
Objective:
We present a case of Kasabach-Merritt syndrome with discussion of hemangiomas of childhood relevant to the emergency physician.
Design:
This is a case report.
Setting:
The case is described in the setting of a tertiary care hospital level I pediatric emergency department.
Patients:
A single case is discussed.
Interventions:
The patient's condition was diagnosed and referred to the appropriate hematology service. Methylprednisolone (2 mg/kg/day) therapy was instituted.
Conclusions:
Children may present to the emergency department with a mass requiring diagnosis. The emergency physician must efficiently and economically identify the cause and complications from a variety of etiologies. Hemangiomas with complicating thrombocytopenia and microangiopathic hemolysis are rare and must be correctly identified. The emergency physician should occasionally review such unusual diagnoses to maintain their differential diagnosis skills.
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