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Case Reports
. 2023 Mar 21;15(3):e36459.
doi: 10.7759/cureus.36459. eCollection 2023 Mar.

A Case Report of Congenital Afibrinogenemia and Literature Review of Management of Post-circumcision Bleeding

Imteyaz Khan  1 , Matthew Chow  2 , Shakuntala Chandra  1 , Mark Hiatt  1
Affiliations
Case Reports

A Case Report of Congenital Afibrinogenemia and Literature Review of Management of Post-circumcision Bleeding

Imteyaz Khan et al. Cureus. .

Abstract

We present a case of bleeding from circumcision in a full-term newborn male resulting from a rare coagulopathy, congenital afibrinogenemia, and a review of the literature regarding the management of bleeding after circumcision. Bleeding was managed with silver nitrate, suturing, thrombin powder, AristaTM AH (absorbable hemostatic particles; Becton, Dickinson and Company, Franklin Lakes, USA), FFP (fresh frozen plasma), and cryoprecipitate. The Fibrinogen level was less than 30 mg/dl (ref 150-430 mg/dl). The diagnosis of congenital afibrinogenemia was confirmed by a gene test. The baby was found to have a heterozygous pathogenic variant (c.510+1G>T) and a heterozygous likely pathogenic variant (c.1037del) in the FGA gene.

Keywords: afibrinogenemia; fibrin glue; male circumcision; post circumcision bleeding; coagulopathy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flowchart for management of post-circumcision bleeding in newborns.
H/O: history of; f/u: follow up; CBC: complete blood count; PT: prothrombin time; aPTT: activated partial thromboplastin time; INR: international normalized ratio
See this image and copyright information in PMC

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