Severe cervical dysplasia and nasal cartilage calcification following prenatal warfarin exposure.
We present an infant who was exposed to warfarin throughout pregnancy and has warfarin embryopathy. When the child was examined radiologically at 20 months areas of calcification were visible in the septal and alar cartilages of the small external part of the nose. The location of this ectopic calcification is consistent with that seen in an animal model of the warfarin embryopathy. It supports the hypothesis that warfarin interferes with the prenatal growth of the cartilaginous nasal septum by inhibiting the normal formation of a vitamin K-dependent protein that prevents calcification of cartilage. The child also had severe abnormalities of the cervical vertebrae and secondary damage to the spinal cord. Cervical vertebral anomalies are a relatively common finding in the warfarin embryopathy and in the related Binder syndrome.
Howe
A M
AM
Department of Anatomy and Histology, University of Sydney, NSW, Australia.
Lipson
A H
AH
de Silva
M
M
Ouvrier
R
R
Webster
W S
WS
D000293:Adolescent; D020152:Antithrombin III Deficiency; D002114:Calcinosis / Q000139:chemically induced* / Q000000981:diagnostic imaging; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011859:Radiography; D013118:Spinal Cord Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D014859:Warfarin / Q000009:adverse effects*
D014859:Warfarin