LAPORAN KASUS: PERDARAHAN INTRASEREBRAL PADA ACQUIRED PROTHROMBIN COMPLEX DEFICIENCY ONSET LAMBAT
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Abstract
Latar Belakang: Acquired Prothrombin Complex Deficiency (APCD) adalah pendarahan akibat kekurangan vitamin K. Manifestasi klinis berupa defisit neurologis fokal maupun global yang berhubungan dengan perdarahan intraserebral spontan.
Kasus: Bayi laki-laki 1 bulan mengalami penurunan kesadaran, bangkitan, serta muntah sejak 1 hari sebelumnya. Riwayat injeksi vitamin K dan trauma kepala disangkal. Bayi somnolen, pucat, ubun-ubun menonjol, pupil anisokoria, dan ekstremitas spastik. Pemeriksaan laboratorium menunjukkan trombositosis, pemanjangan partial thromboplastin time (PT) dan activated partial thromboplastin time (APTT). CT sken menunjukkan perdarahan intraserebral multipel, subarakhnoid, dan subdural, iskemia luas, dan fluid-fluid level. Pasien diterapi dengan asam traneksamat, vitamin K, antikonvulsan, dan dirujuk ke RS dengan fasilitas layanan bedah saraf.
Diskusi: Diagnosis APCD ditegakkan berdasarkan pemanjangan protrombin dan perdarahan spontan yang ditunjang oleh CT sken kepala.
Simpulan: Kasus APCD memiliki tingkat morbiditas dan mortalitas yang tinggi sehingga profilaksis vitamin K pada neonatus sangat penting.
Kata Kunci: APCD, Defisiensi Vitamin K, Perdarahan Intraserebral, Koagulopati, Neonates
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