SEVERE CERVICAL DYSPLASIA AND NASAL CARTILAGE CALCIFICATION FOLLOWINGPRENATAL WARFARIN EXPOSURE

We present an infant who was exposed to warfarin throughout pregnancy and has warfarin embryopathy. When the child was examined radiological ly at 20 months areas of calcification were visible in the septal and alar cartilages of the small external part of the nose. The location o f this ectopic calcification is consistent with that seen in an animal model of the warfarin embryopathy. It supports the hypothesis that wa rfarin interferes with the prenatal growth of the cartilaginous nasal septum by inhibiting the normal formation of a vitamin K-dependent pro tein that prevents calcification of cartilage. The child also had seve re abnormalities of the cervical vertebrae and secondary damage to the spinal cord. Cervical vertebral anomalies are a relatively common fin ding in the warfarin embryopathy and in the related Binder syndrome. ( C) 1997 Wiley-Liss, Inc.