Intracranial hemorrhage associated with vitamin K deficiency in a breastfed infant after intramuscular vitamin K prophylaxis at birth. Follow-up at 18 months

Latini, G.; Quartulli, L.; Mitri, B. De; Vecchio, A Del; Vecchio, C.

doi:10.1080/080352500750043819

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…[1][2][3][4] However, cases of VKDB in exclusively breastfed healthy newborns, despite im prophylaxis at birth, have been described. 6,7 Vitamin K concentration in breast milk are considerably lower than those present in infant formulas (2 vs 25 to 60 mg l À1 ). 5 This may lead to reductions in vitamin K plasma concentration in exclusively breastfed newborns 3 to 4 weeks after birth.…”

Section: Discussionmentioning

confidence: 96%

Late vitamin K deficiency bleeding after intramuscular prophylaxis at birth: a case report

et al. 2009

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We report the case of a 6-week-old female who presented an intracranial hemorrhage due to late vitamin K deficiency bleeding (VKDB). No other evident bleeding sites were present at the moment of diagnosis. Intramuscular vitamin K (1 mg) was administered at birth. She was exclusively breast-fed. No other risk factors for VKDB were detected. Low levels of vitamin K-dependent coagulation factors and their normalization after vitamin K administration confirmed the diagnosis of late VKDB. The present case suggests potential risks related to a single dose of intramuscular vitamin K at birth.

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Section: Discussionmentioning

confidence: 96%

Late vitamin K deficiency bleeding after intramuscular prophylaxis at birth: a case report

et al. 2009

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“…Latini et al [10] and Solves et al [11] reported that 2 cases with ICH due to vitamin K deficiency despite vitamin K prophylaxis at birth did not have any secondary cause. In a study, although 1 mg of vitamin K was administered intramuscularly to 119 breast-fed infants at birth, vitamin K 1 plasma concentrations in these infants were found to be low after the fourth week [12].…”

Section: Discussionmentioning

confidence: 97%

Intracranial Hemorrhage Due to Vitamin K Deficiency After the Newborn Period

Demirören

Yavûz

Çam

2004

Pediatric Hematology and Oncology

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This study presents clinical and laboratory findings and outcome of infants with intracranial hemorrhage (ICH) due to vitamin K deficiency after the newborn period, and evaluates vitamin K prophylaxis. The hospital records of 19 infants with a diagnosis of ICH due to vitamin K deficiency after the newborn period, seen in our clinic in less than 4 years, were retrospectively evaluated. The mean age at onset of the symptoms was 49 +/- 18 days. The most frequent presenting complaints were convulsion (58%), vomiting (47%), and irritability (47%). The most frequent examination findings were coma (74%), fontanel bulging (68%), and absence of pupil reaction (42%). The localizations of the ICHs were as follows: parenchymal (47%), subarachnoid (47%), subdural (42%), and intraventricular (26%). Four patients had used antibiotics and 1 patient had suffered diarrhea before the onset of the symptoms. One patient had a mild hepatic dysfunction that resolved spontaneously in a few weeks and its cause was not found. Mortality was observed in 6 (32%) patients. Ten patients were followed up for a mean period of 26.9 +/- 22.6 months. The follow-up findings were developmental delay (40%), microcephaly (30%), epilepsy (30%), blindness (20%), strabismus (20%), spastic tetraparesis (10%), spastic hemiparesis (10%), growth retardation (10%), and hydrocephaly (10%). Three (30%) patients remained neurologically normal. Vitamin K deficiency leads to death and neurological defects. Vitamin K prophylaxis at birth is therefore a priority. In this series, hepatic dysfunction had been detected in only 1 patient. The authors speculate that additional vitamin K to breast-fed infants with liver problem, antibiotic use, diarrhea, etc., should be considered.

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“…Our study reported a substantial number of ICH (7/50 13.7%) due to vitamin K deficiency bleeding (VKDB) which generally occurs in young infants [ 12 , 13 ]. Although administration of intramuscular vitamin K in the postnatal period has dramatically reduced the incidence VKDB, rare sporadic cases with late onset hemorrhage have been described in exclusively breast-fed children despite this [ 12 , 13 ]. Other causes include malabsorption and hepatobiliary disease.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Intracerebral Hemorrhage in Children: A Report from PICU of a Resource Limited Country

Abbas

Merchant

Nasir

et al. 2016

Critical Care Research and Practice

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Intracerebral hemorrhage (ICH) in children is a rare but disabling disease that accounts for almost half cases of stroke. We report our experience of ICH in children. Retrospective review of medical records of children (1 month-16 years) admitted in Pediatric Intensive Care Unit between January 2007 and December 2014 was done. Data collected included age, gender, presentation, examination findings, neuroimaging done (CT, MRI, and angiography) management (conservative/intervention), and outcome. Results are presented as frequency and percentages. Of the total 50 patients, 58% were male and 26% were <1 year. On presentation 44% had vomiting, 42% had seizures, and GCS < 8 while 40% had altered level of consciousness. Single bleed was present in 88%, 94% had supratentorial bleed, and 32% had intraventricular extension. 72% had bleed volume of <30 mL and 8% had >60 mL. CT scan was done in 98% patients and MRI in 34%, while 6% underwent conventional angiography. 60% patients were managed conservatively, 36% underwent neurosurgical intervention, and 6% underwent radiological vascular intervention. Hematologic causes were identified in 52% patients and vascular malformations in 14% and in 26% no cause could be identified. 26% of patients expired.

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Intracranial hemorrhage associated with vitamin K deficiency in a breastfed infant after intramuscular vitamin K prophylaxis at birth. Follow-up at 18 months

Cited by 5 publications

References 7 publications

Late vitamin K deficiency bleeding after intramuscular prophylaxis at birth: a case report

Late vitamin K deficiency bleeding after intramuscular prophylaxis at birth: a case report

Intracranial Hemorrhage Due to Vitamin K Deficiency After the Newborn Period

Spectrum of Intracerebral Hemorrhage in Children: A Report from PICU of a Resource Limited Country

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