Related Experiment Videos
Vitamin K deficiency--late onset intracranial haemorrhage
N Aydinli1, A Citak, M Calişkan
1Department of Paediatrics, Institute of Child Health, Istanbul University, Turkey.
Insights
Late onset vitamin K deficiency causes severe intracranial hemorrhage in exclusively breastfed infants. Prophylactic vitamin K is crucial to prevent neurological deficits and long-term handicaps in newborns.
Area of Science:
- Pediatrics
- Neurology
- Neonatology
Background:
- Late onset hemorrhagic disease is a serious condition in infants.
- Vitamin K deficiency is a primary cause of this disease.
- Breastfed infants are particularly at risk.
Purpose of the Study:
- To investigate the clinical features and outcomes of late onset vitamin K deficiency.
- To highlight the neurological sequelae of intracranial hemorrhage in affected infants.
- To emphasize the importance of vitamin K prophylaxis.
Main Methods:
- Retrospective study of 11 infants admitted over a 4-year period.
- Analysis of clinical presentations, neurological examinations, and intracranial hemorrhage patterns.
- Long-term follow-up to assess neurological outcomes.
Main Results:
- All infants were breastfed and did not receive vitamin K prophylaxis.
- Common symptoms included seizures, drowsiness, and poor sucking.
- Intracranial hemorrhage was widespread, with 73% experiencing seizure disorders and 46% severe psychomotor retardation post-follow-up.
Conclusions:
- Late onset vitamin K deficiency leads to significant intracranial hemorrhage and severe long-term neurological impairment.
- Vitamin K prophylaxis at birth is essential to prevent these devastating outcomes.
- Early recognition and intervention are critical for managing affected infants.
Abstract:
A retrospective study is presented of the clinical features and outcome of late onset haemorrhagic disease due to vitamin K deficiency in 11 babies who were admitted to the emergency or child neurology unit during a 4-year period (January 1994-December 1997). The disease occurred in infants between 30 and 119 days of age (mean: 56+/-24 days). None of them received vitamin K after birth and all were breastfed. The presenting complaints were seizures (91%), drowsiness (82%), poor sucking (64%), vomiting (46%), fever (46%), pallor (46%), acute diarrhoea (27%), irritability and high-pitched cry (18%). On examination, tense or bulging fontanelle (73%), anisocoria (36%), weak neonatal reflexes (18%), cyanoses (18%) were the most frequent findings. The localizations of the intracranial haemorrhage were as follows: intracerebral (91%), subarachnoid (46%), subdural (27%), and intraventricular (27%). No fatality was observed. However, after a follow-up period ranging from 6 to 48 months (mean: 21+/-13 months), only three (27%) infants remained neurologically normal. Seizure disorders (73%), severe psychomotor retardation (46%), cerebral palsy (46%) and microcephaly (46%) were observed in the remainder. Hydrocephalus developed in three (27%) babies but none of them required shunt replacement. The value is emphasized of vitamin K prophylaxis in the newborn to reduce the incidence of late onset intracranial haemorrhage and handicap in children.