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[Late manifestation of vitamin K deficiency in breast fed infants]
Insights
Late vitamin K deficiency can occur in breastfed infants, even with initial oral treatment. Alpha-1-antitrypsin deficiency may be an underlying factor in severe cases requiring further investigation.
Area of Science:
- Pediatrics
- Hematology
- Nutritional Science
Background:
- Vitamin K deficiency can manifest late in exclusively breastfed infants.
- Infants may present with bleeding complications beyond the neonatal period.
- Underlying genetic conditions can influence vitamin K metabolism and requirements.
Observation:
- Two breastfed infants presented with late-onset vitamin K deficiency.
- The first infant had no identifiable underlying condition.
- The second infant was diagnosed with alpha-1-antitrypsin deficiency (Pi type ZZ).
Findings:
- The second infant initially responded to oral vitamin K (3 mg).
- However, severe intracranial hemorrhage recurred three weeks later due to vitamin K deficiency.
- This highlights potential challenges in managing vitamin K status in infants with specific genetic disorders.
Implications:
- Infants with alpha-1-antitrypsin deficiency may have unique vitamin K requirements.
- Extended monitoring and potentially adjusted vitamin K supplementation protocols are crucial for these infants.
- Further research is needed to elucidate the relationship between alpha-1-antitrypsin deficiency and vitamin K metabolism.
Abstract:
Two breast fed infants had late manifestations of Vitamin K deficiency. No underlying disease was found in the first case. The second patient was found to have alpha 1-Antitrypsin deficiency (Pi type ZZ). The latter patient initially responded well to a single dose of vitamin K administered orally (3 mg). However, three weeks later, he was admitted to our hospital with severe intracranial hemorrhage due to severe vitamin K deficiency. Vitamin K requirements in infants and clinical characteristics of vitamin K deficiency in infants older than 1 week are discussed.