Severe Rifampicin-induced Vitamin K Deficiency Coagulopathy in a Child

Area of Science:

• Pediatrics
• Pharmacology
• Hematology

Background:

• Tuberculosis treatment often involves multiple medications.
• Vitamin K is essential for blood clotting.
• Drug-induced coagulopathy is a potential adverse effect.

Observation:

• An 8-month-old infant on tuberculosis treatment developed extensive ecchymotic lesions.
• The infant presented with severe coagulopathy, indicating vitamin K deficiency.

Findings:

• The coagulopathy was consistent with vitamin K deficiency, affecting clotting factors II, VII, IX, and X.
• Treatment with vitamin K and plasma administration successfully reversed the coagulopathy.
• This case highlights a rare instance of rifampicin-induced vitamin K deficiency.

Implications:

• Clinicians should consider vitamin K deficiency in infants presenting with bleeding during tuberculosis treatment, especially when using rifampicin.
• Rifampicin may inhibit the vitamin K cycle, necessitating vigilant monitoring for coagulopathy.
• Early recognition and intervention are crucial for managing drug-induced vitamin K deficiency.