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

Latini, Giuseppe; Quartulli, Lorenzo; Mitri, B De; Vecchio, Antonio Del; Vecchio, C

doi:10.1111/j.1651-2227.2000.tb00397.x

Cited by 10 publications

(3 citation statements)

References 15 publications

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“…Frequent occurrence of intracranial bleeding and high mortality rate in our patients correspond with reported severity of late VKDB [1,2]. A single case of failure of IM prophylaxis to prevent late VKDB, initiated the Italian Society of Neonatology to recommend 25 μg of vitamin K per day orally during the first three months of life for all breastfed infants, previously given an IM injection of vitamin K at birth [2,11]. To date, no adverse effects even of higher intake of vitamin K by standard milk formula containing 50-60 μg/l have been reported [1,2,21,22].…”

Section: Discussionsupporting

confidence: 58%

“…However, several reports of late VKDB occurring after IM prophylaxis called into question the traditional belief in the superiority of such an approach. In addition to some sporadic single cases [10,11,12], a case series of otherwise healthy infants with failure of postnatal IM injection of vitamin K 1 to prevent late VKDB has recently been reported from Turkey, Egypt, India and Albania [13][14][15][16][17][18][19]. Whilst these papers focus on intracranial hemorrhage as the main consequence of the late VKDB, we present the largest European group of patients with the late VKDB despite IM administration of vitamin K 1 at birth.…”

Section: Introductionmentioning

confidence: 99%

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Late vitamin K deficiency bleeding despite intramuscular prophylaxis at birth - is there a need for additional supplementation?

et al. 2017

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Introduction/Objective. Vitamin K deficiency is common in newborn infants and without prophylaxis there is a risk of vitamin K deficiency bleeding (VKDB). The most frequent prophylactic approach is an intramuscular (IM) injection of vitamin K1 immediately after birth. Its efficiency to prevent late VKDB has been recently questioned by several reports. Based on our experience, we discuss the need for additional vitamin K1 supplementation after its IM administration at birth. Methods. We present a retrospective review of 12 infants, 11 with confirmed and one with probable late VKDB despite IM prophylaxis at birth, who were treated in the two largest tertiary care pediatric hospitals in Serbia during the last 15 years. Results. All the patients were exclusively breastfed. In 11 patients, daily weight gain was normal or increased, and one patient had failure to gain weight. Six infants were previously healthy, three infants received antibiotics prior to bleeding, and in two diarrhea and cholestasis, respectively, existed previously. An intracranial bleeding was documented in nine infants, four of whom died. Conclusion. Low content of phytomenadione in human milk could occasionally be attributed to late VKDB despite postnatal IM injection of vitamin K1 in otherwise healthy, exclusively breastfed infants. This might be aggravated by transient disturbance of vitamin K turnover due to antibiotic use, acute diarrhea, or transient cholestasis. We suggest that an additional vitamin K1 supplementation after postnatal IM prophylaxis could be justified in exclusively breastfed infants.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Late vitamin K deficiency bleeding despite intramuscular prophylaxis at birth - is there a need for additional supplementation?

et al. 2017

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“…KVEBK sadece anne sütüyle beslenenlerde ve doğum sonrasi K vitamini yapilmayanlarda görülür. Ancak doğum sonrasi K vitamini yapilmiş hastalarda da KVEBK geliştiği bildirilmiştir [16,17]. Bizim olgumuzun da başvuru şikayeti doğumdan sonra K vitamini uygulanmiş olmasina rağmen tekrarlayan göbek kanamasi idi.…”

Section: Olgu Sunumuunclassified

Niemann-pick type a: A rare case presenting with late onset bleeding due to Vitamin K deficiency

Sayar¹,

Baştürk²,

Yılmaz³

et al. 2017

Pau Med J

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ÖzetK vitamini eksikliğine bağli kanama (KVEBK) nadir görülmekle birlikte erken süt çocukluğu döneminde hayati tehdit edebilir. Kanamanin görülme zamanina göre erken (0-1 gün), klasik (1-7 gün) ve geç (8 gün-6 ay) KVEBK olarak siniflandirilir. Kanamanin en sik 3-8 hafta arasinda başladiği geç tipte genellikle daha önce tani konmamiş kolestaz mevcuttur. Niemann Pick hastaliği, sfingomyelin birikimi sonucu köpüksü histiyositleri andiran özel depo hücreleriyle ilişkili bir grup lizozomal depo hastaliğidir. Hastaliğin A ve C tipinde yenidoğan döneminde kendiliğinden gerileyen kolestaz gelişebileceği bilinmektedir. Bir ayliktan itibaren üç defa göbeğinden kanama olmasi nedeniyle tarafimiza başvuran iki aylik hastanin tetkiklerinde PT ve PTT uzamasi mevcuttu. Geç tip KVEBK için bir risk faktörü olan kolestaz araştirildi ve saptandi. K vitamini uygulamasi sonrasi kanama tekrarlamadi. Takiplerinde kolestazi gerileyen ancak karaciğer ve dalak boyutlari artan hastanin ileri incelemeleri sonucunda SMPD1 geninde homozigot yeni bir mutasyon gösterilerek Niemann-Pick tip A tanisi kondu. Bu yazida K vitamini eksikliğine bağli göbek kanamasi ile gelen ve ilk defa bildirilen Nieman-Pick hastaliği tip A tanili olgu sunuldu. 2017;(2):192-195 Anahtar sözcükler: Nieman-pick tip a, K vitamini, kanama, kolestaz. Pam Tıp Derg AbstractVitamin K Deficiency Bleeding (VKDB) is seen rarely and it may be life-threatening during early infancy. VKDB is classified according to bleeding times as early (0-1 day), classical (1-7 days) and late (8 days to 6 months). Undiagnosed cholestasis is usually present in the late type in which the bleeding commonly starts in 3-8 weeks. Niemann Pick disease is a type of lysosomal storage disease associated with special storage cells which are very similar to foamy histiocytes which occurs due to sphingomyelin build-up. It's known that cholestasis may develop and go away on its own among new-born with type A or C of the disease. PT and aPTT were prolonged in 2-month-old patient who presented with umbilical bleeding which happened three times after 1-month-old. Cholestasis was investigated and diagnosed which is a risk factor for late type VKDB. Bleeding had not repeated after Vitamin K administration. The patient was diagnosed with Niemann-Pick Type A by showing a new homozygos mutation in SMPD1 gene after advanced investigations because of liver and spleen enlargement despite cholestasis was regressing during follow-up. This article is presenting a rare case diagnosed with Niemann-Pick Type A for the first time presented with umbilical bleeding due to Vitamin K deficiency.Pam Med J 2017;10(2):192-195

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Intracranial hemorrhages due to late-type vitamin K deficiency bleeding

et al. 2007

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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 10 publications

References 15 publications

Late vitamin K deficiency bleeding despite intramuscular prophylaxis at birth - is there a need for additional supplementation?

Late vitamin K deficiency bleeding despite intramuscular prophylaxis at birth - is there a need for additional supplementation?

Niemann-pick type a: A rare case presenting with late onset bleeding due to Vitamin K deficiency

Intracranial hemorrhages due to late-type vitamin K deficiency bleeding

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