Nmadu Yeka W, Bernhard Joseph, Klawinski Amanda, Klawinski Darren, Shah Chetan, Nakagawa Thomas
Pediatrics, University of Florida College of Medicine, Jacksonville, USA.
Emergency Medicine, University of Florida College of Medicine, Jacksonville, USA.
Cureus. 2024 Jul 8;16(7):e64098. doi: 10.7759/cureus.64098. eCollection 2024 Jul.
A four-week-old full-term male infant presented to the emergency department with blood in the diaper, increasing lethargy, and vomiting and was found to have multiple intracranial hemorrhages on CT. He was delivered at home and did not receive vitamin K. Coagulation studies were abnormal, and des-gamma carboxyprothrombin (DCP) was 481, diagnostic of vitamin K deficiency. He received vitamin K and required multiple antiepileptic medications for seizure control. Vitamin K deficiency bleeding (VKDB) is a preventable disease that can have devastating consequences and could present as early, classical, or late-onset. The typical presentation manifests with cutaneous, gastrointestinal, or intracranial hemorrhage most commonly in fully breastfed infants. Vitamin K prophylaxis has proven to be effective. With increasing out-of-hospital delivery and online misinformation, there is a declining administration of intramuscular vitamin K at birth. It is the responsibility of healthcare providers to properly inform patients and their families of the importance of vitamin K prophylaxis at or before the time of delivery.
一名4周大的足月男婴因尿布中有血、嗜睡加重和呕吐被送往急诊科，CT检查发现有多处颅内出血。他在家中出生，未接受维生素K。凝血研究异常，脱γ羧基凝血酶原（DCP）为481，诊断为维生素K缺乏。他接受了维生素K治疗，并需要多种抗癫痫药物来控制癫痫发作。维生素K缺乏性出血（VKDB）是一种可预防的疾病，可能会产生严重后果，可表现为早发型、经典型或晚发型。典型表现最常见于纯母乳喂养的婴儿，表现为皮肤、胃肠道或颅内出血。维生素K预防已被证明是有效的。随着院外分娩的增加和网上错误信息的传播，出生时肌肉注射维生素K的情况在减少。医疗保健提供者有责任在分娩时或分娩前适当地告知患者及其家属维生素K预防的重要性。
