DOI: 10.36347/sasjs.2020.v06i01.006

Pages: 20-21

Down syndrome is a chromosomal aberration described for the first time by J. Lejeune and al in 1959. It is indeed the most frequent of the autosomal chromosomal anomalies and one of the main causes of intellectual disability. It is known by its association with several malformations, especially cardiac, digestive and urinary. Ischemia of a limb with no notion of trauma remains a clinical situation little reported in the literature. We report the case of a male newborn admitted for ischemic gangrene of upper extremity. Observation: A male newborn is admitted to the emergency room for functional impotence of the right upper limb. The examination found a Down's syndrome facies and ischemic gangrene of the right upper limb involving the hand and going up to the middle thirds of the right forearm. No notion of trauma to the limb was found during the interrogation. The Doppler ultrasound of the upper limb was in favor of an alteration in the flow of the right ulnar and radial arteries. The cardiac ultrasound showed a CIA with 3 mm ostium segundum, a persistence of an arterial canal. The hemoglobin level was 17g / dl and he had a leukocytosis at 13000g / dl. The diagnosis of idiopathic ischemia of the upper limb on a trisomy 21 site was accepted. He underwent amputation of the forearm, the evolution of which is marked by "suppuration of the stump of the amputation. Conclusion: Idiopathic ischemia in Down's syndrome is a rarely encountered disease. Its early diagnosis and its appropriate management guarantee a good development. Its evolution sometimes leads to complications that can be life-threatening.