title: Late-type vitamin K deficiency bleeding: experience from 120 patients.
abstract: BACKGROUND
  Deficiency of vitamin K predisposes to early, classic, or late vitamin K deficiency bleeding (VKDB), of which late VKDB may be associated with serious and life-threatening intracranial bleeding. Late VKDB is characterized with intracranial bleeding in infants aged 2-24 weeks due to severe vitamin K deficiency, occurring primarily in exclusively breast-fed infants. Late VKDB is still an important cause of mortality and morbidity in developing countries.
  
  
  METHODS
  We presented 120 cases of late VKDB, which were evaluated at Erciyes University Medical Faculty Hospital between June 1990 and June 2006.
  
  
  RESULTS
  Signs and symptoms of the patients were bulging fontanels (70%); irritabilities (50%); convulsions (49%); bleeding and ecchymosis (47%); feeding intolerance, poor sucking, and vomiting (46%); diarrhea (34%); jaundice (11%); and pallor (9%), and among these infants, 21% received medication before the diagnosis (10%, antibiotics; 3%, simethicone; 4%, paracetamol; and 4%, phenobarbital). Intracranial hemorrhage in 88 (73%) patients has been observed. The hemorrhage was subdural in 34 (28%) cases, intracerebral in 28 (23%), subarachnoid in 17 (14%), intraventricular in 9 (8%), intracerebral and subdural in 12 (10%), subdural and subarachnoid in 6 (5%), and combination of intracerebral, subdural, and intraventricular in 14 (12%), and the mortality rate was 31%.
  
  
  CONCLUSIONS
  Although late VKDB leads to significant morbidity and mortality, it can be avoided by providing vitamin K prophylaxis to all newborns. Administration of vitamin K (1 mg) at birth can prevent intracranial bleeding and other hemorrhagic manifestations.
authors.affiliation: Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Talas, Kayseri, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Ozdemir
authors.forename: Musa
authors.initials: M
authors.lastname: Karakukcu
authors.forename: Huseyin
authors.initials: H
authors.lastname: Per
authors.forename: Ekrem
authors.initials: E
authors.lastname: Unal
authors.forename: Hakan
authors.initials: H
authors.lastname: Gumus
authors.forename: Turkan
authors.initials: T
authors.lastname: Patiroglu
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D008297:Male; D012189:Retrospective Studies; D014813:Vitamin K Deficiency / Q000150:complications* / Q000175:diagnosis* / Q000401:mortality