CASE REPORT article
Front. Pediatr.
Sec. Pediatric Critical Care
Volume 13 - 2025 | doi: 10.3389/fped.2025.1690450
Case Report: Life-threatening Kasabach-Merritt Phenomenon in a two-month-old
Provisionally accepted
Ashley Victoria Wong Grossman1,2*
Juan Pablo Forero2Jeffrey S. Yu2Megan M. Gilbert2
Kanwaljeet J. S. Anand2- 1Mayo Clinic, Rochester, United States
- 2Lucile Packard Children's Hospital Stanford, Palo Alto, United States
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We present a rare case of a term, 2-month-old female who is admitted to the pediatric intensive care unit for fussiness, increasing abdominal distension, and intermittent diarrhea for one week. She is found to be hypertensive, coagulopathic, and suffers from unrelenting ascites. Over the course of the next month, her symptoms become life-threatening, and she is intubated, sedated, and paralyzed. She undergoes multiple diagnostic and therapeutic procedures, including exploratory laparotomy, MRI, colonoscopy, and multiple peritoneal drains. After several weeks, the medical teams align on diagnosing her with a rare complex vascular anomaly characterized by life-threatening Kasabach-Merritt Phenomenon (KMP) which can be seen in a several anomalies including kaposiform hemangioendothelioma (KHE) and kaposiform lymphangiomatosis (KLA). Life-saving therapies are initiated, including methylprednisolone and sirolimus. The patient is ultimately discharged home with her parents. This case is the only one known to describe this constellation of symptoms in a critically-ill infant. Multi-disciplinary cooperation was key in saving the patient's life. Critical care providers should consider vascular anomalies in patients with similar presentations.
Keywords: Infant, lymphatic disorder, tumor, Coagulopathic bleeding, vascular malformation
Received: 21 Aug 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Wong Grossman, Forero, Yu, Gilbert and Anand. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ashley Victoria Wong Grossman, ashleyvwong@gmail.com
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