Late hemorrhagic disease of the newborn as a cause of intracerebral bleeding.
We report a case of a 4-week-old female who presented with late hemorrhagic disease of the newborn (HDN). The newborn was previously healthy, and she received 1 mg of intramuscular vitamin K at birth. She was exclusively breast-fed. At 4 weeks she began bleeding at the umbilicus and 4 days after she suffered an intracranial hemorrhage. Coagulation studies showed a deficiency of vitamin K-dependent coagulation factors, and the normalization of all clotting studies after administration of vitamin K confirmed the diagnosis of HDN. Our conclusions are that physicians must be alert to mild bleeding in newborns and that prophylaxis with 1 mg of intramuscular vitamin K at birth may be insufficient to prevent late HDN.
Solves
P
P
Department of Hematology, Hospital de Sant Pau, Barcelona, Spain.
Altés
A
A
Ginovart
G
G
Demestre
J
J
Fontcuberta
J
J
D017668:Age of Onset; D002543:Cerebral Hemorrhage / Q000209:etiology*; D003937:Diagnosis, Differential; D005177:Factor XIII Deficiency / Q000175:diagnosis; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008107:Liver Diseases / Q000175:diagnosis; D014812:Vitamin K / Q000008:administration & dosage; D006475:Vitamin K Deficiency Bleeding / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control
D014812:Vitamin K