Neonatal Thymic Hemorrhage Secondary to Vitamin K Deficiency: A Case Report

Vitamin K deficiency bleeding (VKDB) in newborns is a preventable yet serious condition. Maternal malabsorption, such as in Crohn's disease, may impair transplacental vitamin K transfer, increasing neonatal coagulopathy risk.

A 32-year-old woman with Crohn's disease and prior bowel resections delivered at 35+3 weeks due to preeclampsia and fetal distress. Her infant developed severe coagulopathy and a hemorrhagic thymic mass. Laboratory results showed elevated INR and PIVKA-II, which improved with vitamin K and plasma. The mother experienced postpartum hemorrhage and coagulopathy, requiring transfusions, embolization, and vitamin K. Both recovered with treatment. At 13 months, the infant showed only mild left-hand weakness and normal development.

This case highlights the risk of neonatal VKDB and maternal bleeding due to undiagnosed maternal vitamin K deficiency. Screening and supplementation should be considered in pregnancies affected by malabsorptive disorders like Crohn's disease.