Table of Contents

HK J Paediatr (New Series)
Vol 20. No. 2, 2015

HK J Paediatr (New Series) 2015;20:80-85

Original Article

Intracranial Haemorrhage Due to Late-Onset Vitamin K Deficiency
晚發性維生素K缺乏導致的顱內出血

M Karaci, E Toroslu, T Karsli, Y Kanber, S Uysal, D Albayrak


Abstract

Objective: Deficiency of vitamin K predisposes to bleeding and it can be divided into early, classical, or late vitamin K deficiency bleeding (VKDB) according to their onset. Late VKDB occurs after 7th day of life at neonatal period and is associated with intracranial bleeding, serious neurological sequels and death. This retrospective study reviewed the clinical presentations, demographic features and radiological findings of infants with intracranial haemorrhage due to late-onset VKDB. Materials and methods: We identified 26 cases of late VKDB admitted to our hospital from February 1992 to November 2006. Cranial computerised tomography was performed in all patients at diagnosis and at subsequent evaluation. Results: Sixteen of twenty-six patients with late VKDB (61.5%) had intracranial haemorrhage (ICH). The mean age of these 16 patients with ICH was 1.6±0.7 months. All of them were on breastfeeding. Eighteen of them received one mg of vitamin K intramuscularly (IM) shortly after birth. None of them received any other medication. The most common sign and symptom of patients with ICH was bulging fontanel (69%). The most common bleeding site as parenchymal (n=7, 43.7%). The mortality rate was 44% among patients with ICH. Conclusion: For neonates on strict breast-feeding, despite some with vitamin K prophylaxis, some patients still may suffer from intracranial and extracranial bleeding due to vitamin K deficiency. Therefore, additional IM dose of vitamin K may be needed. However, further evidence from larger prospective study is needed to verify this observation.

目的:維生素K缺乏可導致出血,根據其發生時間可以分為早發性、經典性和晚發性維生素K缺乏出血(VKDB)。晚發性VKDB發生在出生7天之後的新生兒期,通常合併顱內出血,嚴重的神經系統後遺症和死亡。本文回顧性總結了晚發性VKDB導致顱內出血的嬰兒的臨床表現,人口學特徵以及影像學表現。資料和方法:從1992年2月至2006年10月,我院共收治26例晚發性VKDB患兒。在初診和隨後隨訪中均進行了頭部電腦斷層掃描檢查。結果:26例晚發性VKDB中有16例(61.5%)患兒合併顱內出血(ICH),伴有ICH的16名患兒平均年齡為1.6±0.7個月。所有患兒均為母乳餵養。其中18例患兒出生後很快即接受1 mg維生素K肌肉注射。所有患兒都沒有接受過其他藥物。ICH最常見的臨床表現和體徵是囟門膨出(69%)。最常見的出血部位是腦實質(n=7,43.7%)。合併ICH的患兒死亡率是44%。結論:對於純母乳餵養的新生兒,雖然有些已經進行了維生素K的預防性注射,但是部份患兒仍然會因為維生素K缺乏而出現顱內外的出血。因此,額外劑量的維生素K仍然是需要的。不過該結論尚需要更大樣本的前瞻性試驗才可證實。

Keyword : Children; Intracranial haemorrhage; Vitamin K deficiency bleeding

關鍵詞:兒童、顱內出血、維生素K缺乏出血

 
 

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