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

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 × 10³/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.