Safe Endoscopic Treatment for a Bleeding Infant With Multifocal Lymphangioendotheliomatosis and Thrombocytopenia (MLT)

ABSTRACT We present the case of a 3-week-old girl with multiple cutaneous vascular lesions, melena, hematemesis, severe anemia (hemoglobin 4.4 g/dL), and thrombocytopenia (72 × 10 3 /µL), with clinical features consistent with multifocal lymphangioendotheliomatosis with thrombocytopenia (MLT). Upper gastrointestinal endoscopy revealed numerous actively bleeding angiomatous lesions, measuring 1–3 mm in diameter. Homeostasis was successfully achieved using argon plasma coagulation (APC). To our knowledge, this is among the few reports describing the effective use of APC in managing life-threatening gastric hemorrhage in an infant with MLT. While gastrointestinal perforation has been previously reported as a complication of endoscopic therapy in this context, our findings suggest that APC may be a viable option for refractory bleeding, provided that surgical support is immediately accessible.