The transitory absence of several clotting factors in a newborn baby.

Haemorrhagic diathesis of the newborn is usually characterized by a physiological deficiency of prothrombin and probably also by a deficiency of proconvertin (van Creveld, Paulssen, Ens, Mey, Versteegh and Versteeg, 1954). Sometimes a third clotting-factor, pro-accelerin, is also lacking. We found a simultaneous deficiency both of prothrombin and pro-accelerin in some cases of intra-uterine melaena and of haemolytic disease of the newborn; it is also found in severe congenital damage of the liver (van Creveld, Paulssen and Teng, 1952). We do not know how far in such permanent congenital haemorrhagic diatheses as haemophilia, fibrinopenia and Christmas disease other clotting factors are transiently lacking after birth, as well as a temporary shortage of prothrombin and a permanently deficient specific clotting factor. Except in these instances we can say that no cases of a haemorrhagic diathesis in the newborn are known where a deficiency of more than three clotting-factors is found. We were able to observe a transitory haemorrhagic diathesis in a young infant in whom four clottingfactors were simultaneously deficient. It was remarkable that this deficiency involved just those clotting-factors which are necessary for the whole second phase of the coagulation process.