title: Intracranial hemorrhage in infants as a serious, and preventable consequence of late form of vitamin K deficiency: a selfie picture of Turkey, strategies for tomorrow.
abstract: OBJECTIVE
  Vitamin K deficiency bleeding is one of the most common causes of acquired hemostatic disorder in early infancy. Although vitamin K is practiced routinely after every birth in Turkey, children with type of vitamin K deficiency bleedings (L-VKDB) can be encountered. We aimed to evaluate the clinical features of the children with L-VKDB reported from Turkey.
  
  
  METHODS
  Between 1995 and 2013, 48 studies reporting 534 children with L-VKDB were evaluated in this study.
  
  
  RESULTS
  Of the 534 reported children (178 girls, 356 boys), 486 (91 %) were extremely breastfed. The most common bleeding sites were intracranial hemorrhage, gastrointestinal, and umbilical in 414 (77.4 %), 33 (6.2 %), and 33 (6.2 %) children, respectively, and 35 (6.6 %) children had been diagnosed incidentally without any bleeding. The etiology of 399 (74.7 %) children were classified as idiopathic, whereas 135 (25.3 %) were secondary. Intramuscular vitamin K was administered in 248 (46.4 %), not administered in 228 (42.7 %), and the administration of vitamin K were not determined in 58 (10.9 %) children. The outcomes of Turkish cohort showed that 111 (20.8) children died, 257 (48.1 %) cases developed neurologic deficit (mainly epilepsy and psychomotor retardation), and only 166 (31.1 %) patients recovered without squeal.
  
  
  CONCLUSIONS
  The compliance of prophylactic measures in Turkey does not seem to be satisfactory. As a further measure of tomorrow, we vigorously emphasize that a national surveillance program may be initiated. An additional intramuscular dose or oral supplementation of vitamin K especially for exclusively breast-fed infants may reduce this catastrophic problem in our country.
authors.affiliation: Department of Pediatrics, Division of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes University, 38039, Talas, Kayseri, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Unal
authors.forename: Serkan
authors.initials: S
authors.lastname: Ozsoylu
authors.forename: Ayse
authors.initials: A
authors.lastname: Bayram
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Ozdemir
authors.forename: Ebru
authors.initials: E
authors.lastname: Yilmaz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Canpolat
authors.forename: Abdulfettah
authors.initials: A
authors.lastname: Tumturk
authors.forename: Huseyin
authors.initials: H
authors.lastname: Per
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology; D014812:Vitamin K / Q000627:therapeutic use; D006475:Vitamin K Deficiency Bleeding / Q000150:complications* / Q000453:epidemiology
chemical_list: D014812:Vitamin K
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