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Vitamin K deficiency presenting with hemarthrosis
Insights
A breast-fed infant presented with leg swelling and bleeding, initially suspected as septic arthritis. Prompt vitamin K1 administration corrected coagulation, highlighting the importance of differentiating hemarthrosis from vitamin K deficiency in neonates.
Area of Science:
- Pediatrics
- Hematology
- Orthopedics
Background:
- Neonatal bleeding disorders can present with musculoskeletal symptoms.
- Distinguishing between infectious and metabolic causes of joint swelling is critical for appropriate management.
Abstract:
A breast-fed 25-day-old infant was hospitalized because of swelling and tenderness of the left leg, developed after mild rotary motion of the leg by his brother. Radiographic examination showed widening of the left articular hip joint space. On the day of admission, a presumptive diagnosis of septic arthritis was entertained, and antibiotic therapy was instituted. Following profuse bleeding from sites of skin punctures, coagulation studies were performed. Prothrombin time and partial thromboplastin time were prolonged. Administration of phylloquinone (vitamin K1) resulted in rapid normalization of coagulation. Differential diagnosis between hemarthrosis resulting from vitamin K deficiency and septic arthritis with disseminated intravascular coagulation is a matter of great importance in such patients.