Dynamic changes and influencing factors of vitamin K levels in neonates / 中国新生儿科杂志

Objective:To study the incidences of vitamin K 1 and K 2 deficiency (VKD) in umbilical cord blood (UBC) of neonates and the dynamic changes and influencing factors of serum vitamin K 1 levels after preventive vitamin K 1 supplementation. Methods:From January 2021 to June 2022, neonates born in the Obstetrics Department of our hospital were prospectively enrolled and the levels of vitamin K 1 and K 2 in UBC and serum vitamin K 1 levels at 14 d and 28 d after vitamin K 1 supplementation were measured. The neonates were assigned into hospitalization group and healthy group and further assigned into early-preterm, late-preterm and full-term groups based on gestational age (GA). The incidences of VKD of different GA were studied. Dynamic changes of vitamin K 1 levels were calculated. Multivariate logistic regression was used to analyze the influencing factors of vitamin K 1 levels in hospitalization group at 28 d. Results:A total of 100 neonates were included. 80 neonates were hospitalized, including 25 early-preterm, 25 late-preterm and 30 full-term. 20 were healthy full-term neonates. No significant differences existed in the incidences of VKD of different GA ( P>0.05), however, the overall incidences were high (82.0% and 84.0%, respectively). After preventive vitamin K 1 supplementation, the levels of vitamin K 1 in full-term and preterm groups at 14 d were higher than at birth and 28 d. The levels of vitamin K 1 in hospitalized full-term neonates at 14 d and 28 d were higher than hospitalized preterm neonates. The levels of vitamin K 1 at 28 d in healthy group was significantly higher than hospitalization group ( P<0.05). Multivariate logistic regression analysis showed that maternal complications during pregnancy ( OR=5.889, 95% CI 1.621-21.399, P=0.007) and neonatal antibiotic use ( OR=5.615, 95% CI 1.833-17.221, P=0.003) were risk factors and formula feeding ( OR=0.389, 95% CI 0.193-0.786, P=0.008) was a protective factor for VKD. Conclusions:VKD is common in neonates. The serum vitamin K 1 level increases significantly after preventive vitamin K 1 supplementation. The vitamin K 1 levels of hospitalized full-term neonates at 14 d and 28 d are higher than hospitalized preterm neonates. The levels of vitamin K 1 at 28 d in hospitalized neonates are influenced by feeding methods, maternal complications during pregnancy and neonatal antibiotic use.

Late vitamin K deficiency bleeding in infants: five-year prospective study

Abstract Objective: To study the presenting clinical and demographic features, risk factors, and outcome of infants with late vitamin K deficiency bleeding. Methods: Over a 5-year study period, the presenting clinical features and outcome of all 47 infants observed aged less than 6 months, who were diagnosed with late-onset primary and secondary VKDB by detailed history, physical examination, and laboratory findings were evaluated. Confirmed primary late VKDB was diagnosed when no cause other than breastfeeding could be found, while in the secondary subtype additional risk factors compromising the vitamin K effect were diagnosed. Results: Secondary late VKDB (83%, 39 patients) was more common than the primary subtype. The mean age of patients was 10.50 ± 5.75 and 9.74 ± 6.04 weeks in primary and secondary VKDB subtypes, respectively, and the age of infants did not have a significant difference (> 0.05). The male to female ratio was 2.13:1. The residency, place and mode of delivery, gestational age, and types of feeding of patients did not have a significant difference between VKDB subtypes. The skin and gastrointestinal tract (GIT) (40.4%) followed by intracranial hemorrhage (ICH) (32%), were common sites of bleeding. Neurological complications were seen in 21% of patients; however, lethality was 23%, and the outcome of patients did not have a significant difference (p > 0.05) between VKDB subtypes. Conclusion: Secondary late VKDB is more common than the primary subtypes, and late VKDB is still a serious disease in developing countries, including Iraq, when vitamin K prophylaxis isn't routinely used at birth.

Coagulopatía asociada a síndrome de malabsorción por enfermedad celíaca / Coagulopathy associated with celiac disease malabsorption syndrome

This article describes a 19-y-old patient with abdominal pain and signs of malnutrition. She had been treated previously with an antibiotic for chronic diarrhea. Laboratory analyses showed the presence mild hypoalbuminemia, and considerably prolonged prothrombin time. Tests revealed that hemostasis improved after the patient received fresh frozen plasma and vitamin k. A coagulation profile showed a decrease in clotting factors V, VII, IX, and fibrinogen. Positive serology (immunoglobulin A antitissue transglutaminase and immunoglobulin A antiendomysial antibodies) and small bowel mucosal histopathology confirmed the presence of celiac disease (CD). The girl recovered completely after she was put on a gluten-free diet. Vitamin K­deficiency is a rare complication that occurs in celiac disease manifestations. In addition to antibiotic therapy, treatment with other drugs that influence vitamin K resorption and metabolism may increase the risk of bleeding in patients with CD with hypoprothrombinemia.

Prevención de hemorragias en el posoperatorio temprano de cirugía bariátrica: Papel de la vitamina K / Prevention of hemorrhage in the early postoperative period of bariatric surgery: Role of vitamin K

Introducción: la cirugía bariátrica es el tratamiento más eficaz para la obesidad mórbida. La hemorragia se presenta en el 0,5-5% de las pacientes. La preparación prequirúrgica con dieta líquida y el uso de antibióticos para Helicobacter pylori podría alterar el metabolismo de la vitamina K y asociarse a hemorragia. Objetivo: describir el comportamiento de la concentración de protrombina (basal = B-PT y prequirúrgica = preQ-PT) en estos pacientes. Material y métodos: se realizó un estudio de cohorte prospectivo donde se comparó la concentración de B-PT (15-180 días previos a la cirugía) y la preQ-PT (24 horas previas a la cirugía). Resultados: se incluyeron 194 pacientes, de los cuales el 72% (n = 139) fueron mujeres, de entre 19 y 69 años, con BMI (IMC) 45 (33 a 58) y pérdida de peso prequirúrgica del 7% (-2 a 17). El promedio de B-PT fue 91,9% (DE 9,529), el promedio de la preQ-PT fue 81,1% (DE 10,760); descendió un 10,8% (p < 0,001). No hubo diferencias significativas cuando se comparó el comportamiento en la preQ-PT entre los diferentes subgrupos (uso de antibióticos para Helicobacter pylori, de acuerdo con la pérdida de peso y en relación con la suplementación de vitamina K); sin embargo, siempre se detectó descenso de la preQ-PT. No hubo ninguna complicación hemorrágica (necesidad de transfusiones o reoperación); tampoco hubo muerte por hemorragias ni eventos tromboembólicos. Conclusión: realizar dosaje de protrombina 24 horas antes de la cirugía bariátrica permite detectar alteraciones iatrogénicas de la coagulación inducidas por la dieta y el uso de antibióticos.

Background: bariatric surgery is the most efficient treatment for morbid obesity. Bleeding occurs in 0.5-5% of patients. Pre-surgical preparation with liquid diet and the use of antibiotics for Helicobacter pylori could alter the metabolism of vitamin K and be associated with hemorrhage. Objective: to describe the behavior of the concentration of Prothrombin (basal = B-PT and pre-surgical = preQ-PT) in these patients. Material and methods: a prospective cohort study comparing B-PT concentration (15-180 days prior to surgery) and preQ-PT (24 h prior to surgery) was performed. Results: a total of 194 patients were included in the study, with 72% (n = 139) women aged 19-69 years, BMI 45 (33 to 58) and preoperative weight loss of 7% (-2 to 17). The media B-PT was 91.9% (SD 9.529), the media pre-PT was 81.1% (SD 10.760); declined 10.8% (p <0.001). There was no significant difference when comparing the behavior in the preQ-PT among different subgroups (use of antibiotics for Helicobacter pylori, according to weight loss and in relation to vitamin K supplementation), however, there was always a decrease of the preQ-PT. There were no bleeding complications (need for transfusions or re-intervetion), nor was there death for bleeding or thromboembolic events. Conclusion: prothrombin measurement 24 hours before bariatric surgery allows the detection of iatrogenic coagulation alterations induced by diet and the use of antibiotics.

The clinical experience of diagnosis and treatment of late vitamin K deficiency intracranial hemorrhage as the first symptom of biliary atresia / 天津医药

Objective To investigate the surgical diagnosis and treatment of late vitamin K deficiency intracranial hemorrhage caused by biliary atresia. Methods Clinical data of six cases of biliary atresia with late vitamin K deficiency intracranial hemorrhage were collected in the Department of Neurosurgery of Tianjin Children’s Hospital from January 2000 to December 2013. Data were analyzed to identify the biliary atresia as soon as possible in the treatment of intracranial hemorrhage and prolonged jaundice in children. Results Six cases (1 male, 5 female), mean age was (16.0±2.6) days, and were treated with external drainage of intracranial hematoma and infusion therapy. In the treatment, children were found jaundice exacerbation and doubted about biliary atresia. After consultation by general surgeons, children were transferred to the department of general surgery for further treatment at an average age of (29.1±1.2) days, and were diagnosed as biliary atresia by intraoperative cholangiography. Conclusion Pediatric neurosurgeon should have a sufficient understanding and make an early diagnosis to late vitamin K deficiency intracranial hemorrhage caused by biliary atresia, to avoid delaying the optimal treatment time of biliary atresia.

Prevention and treatment of vitamin K deficiency in neonates and infants / 中华实用儿科临床杂志

Vitamin K deficiency is a common problem in neonates and infants,vitamin K deficiency bleeding can be life threatening.There is still a high incidence of vitamin K deficiency even if the prevention by retrospective analysis a large number of the global data.In recent years,with the increase of premature infants,incidence is higher than before,China is the same trend.There is no recognized prevention and treatment measures,and less related research data.Therefore,to carry out related investigation,to provide the basis for clinical prevention and treatment are an urgent task.

The Influence of Alcoholic Liver Disease on Serum PIVKA-II Levels in Patients without Hepatocellular Carcinoma

BACKGROUND/AIMS: Prothrombin induced by vitamin K deficiency or antagonist II (PIVKA-II) is a widely used diagnostic marker for hepatocellular carcinoma (HCC). We evaluated the correlation between alcoholic liver disease (ALD) and serum PIVKA-II levels in chronic liver disease (CLD) patients. METHODS: We retrospectively reviewed the medical records of 2,528 CLD patients without HCC. Among these patients, 76 exhibited serum high PIVKA-II levels of >125 mAU/mL (group 1). We categorized 76 control patients matched by age, sex, and the presence of liver cirrhosis from the remaining patients who were negative for serum PIVKA-II (group 2). RESULTS: Group 1 revealed increased antibiotic usage (23.7% vs 2.6%, p<0.001) and incidence of ALD (60.5% vs 14.5%, p<0.001) as well as elevated aspartate aminotransferase (52.5 IU/L vs 30.5 IU/L, p=0.025) and gamma glutamyl transpeptidase (67.5 IU/L vs 36.5 IU/L, p=0.005) levels compared with group 2. Further, group 1 was significantly associated with a worse Child-Pugh class than group 2. In the multivariate analysis, ALD (odds ratio [OR], 7.151; p<0.001) and antibiotic usage (OR, 5.846; p<0.001) were significantly associated with positive PIVKA-II levels. CONCLUSIONS: Our study suggests that ALD and antibiotics usage may be confounding factors when interpreting high serum PIVKA-II levels in patients without HCC. Therefore, serum PIVKA-II levels in patients with ALD or in patients administered antibiotics should be interpreted with caution.

The Influence of Alcoholic Liver Disease on Serum PIVKA-II Levels in Patients without Hepatocellular Carcinoma

BACKGROUND/AIMS: Prothrombin induced by vitamin K deficiency or antagonist II (PIVKA-II) is a widely used diagnostic marker for hepatocellular carcinoma (HCC). We evaluated the correlation between alcoholic liver disease (ALD) and serum PIVKA-II levels in chronic liver disease (CLD) patients. METHODS: We retrospectively reviewed the medical records of 2,528 CLD patients without HCC. Among these patients, 76 exhibited serum high PIVKA-II levels of >125 mAU/mL (group 1). We categorized 76 control patients matched by age, sex, and the presence of liver cirrhosis from the remaining patients who were negative for serum PIVKA-II (group 2). RESULTS: Group 1 revealed increased antibiotic usage (23.7% vs 2.6%, p<0.001) and incidence of ALD (60.5% vs 14.5%, p<0.001) as well as elevated aspartate aminotransferase (52.5 IU/L vs 30.5 IU/L, p=0.025) and gamma glutamyl transpeptidase (67.5 IU/L vs 36.5 IU/L, p=0.005) levels compared with group 2. Further, group 1 was significantly associated with a worse Child-Pugh class than group 2. In the multivariate analysis, ALD (odds ratio [OR], 7.151; p<0.001) and antibiotic usage (OR, 5.846; p<0.001) were significantly associated with positive PIVKA-II levels. CONCLUSIONS: Our study suggests that ALD and antibiotics usage may be confounding factors when interpreting high serum PIVKA-II levels in patients without HCC. Therefore, serum PIVKA-II levels in patients with ALD or in patients administered antibiotics should be interpreted with caution.

Hemorrhagic Diathesis as the Presenting Symptom of Neonatal Cholestasis / 대한소아소화기영양학회지

A 4-week-old infant presented with a coagulation disorder resulting from a vitamin K deficiency. The vitamin K deficiency was caused by neonatal cholestasis due to biliary atresia. Jaundice, hepatomegaly and pale stools are the predominant presenting symptoms of biliary atresia, none of which were recognized in our patient before admission. However, the patient presented with bleeding caused by vitamin K deficiency. She was fully breastfed and had received adequate doses of vitamin K at birth and from the age of 1 week. In case of a hemorrhagic diathesis due to neonatal cholestasis, timely identification of treatable underlying disorders, in particular biliary atresia, is important because an early surgical intervention results in a better prognosis. Meticulous history taking and a thorough physical exam can be decisive for an early diagnosis and subsequent intervention.

A Case of Acquired Transient Vitamin K Deficiency in a Teenage Girl / 임상소아혈액종양

A 13-year old girl visited emergency medical center presenting with nasal bleeding and gross hematuria. She had no growth retardation, nor history of abnormal bleeding. Her initial blood test results showed normal platelet counts, normal liver enzyme level but prolonged prothrombin time and activated partial thromboplastin time. On admission, she showed massive but intermittent bleeding until the 15th hospital day. Evaluation including coagulation factor assay was done and the results were compatible with vitamin K deficiency. She was treated with vitamin K intramuscular injection 7 times and intermittent transfusion of red blood cells, platelets and fresh frozen plasma. After that, all of her blood test results returned to normal levels including coagulation tests concomitent with resolving symptoms. In that there were no proof of underlying diseases that can cause vitamin K deficiency, she was diagnosed as idiopathic transient vitamin K deficiency.

A Case of Acquired Transient Vitamin K Deficiency in a Teenage Girl / 임상소아혈액종양

A 13-year old girl visited emergency medical center presenting with nasal bleeding and gross hematuria. She had no growth retardation, nor history of abnormal bleeding. Her initial blood test results showed normal platelet counts, normal liver enzyme level but prolonged prothrombin time and activated partial thromboplastin time. On admission, she showed massive but intermittent bleeding until the 15th hospital day. Evaluation including coagulation factor assay was done and the results were compatible with vitamin K deficiency. She was treated with vitamin K intramuscular injection 7 times and intermittent transfusion of red blood cells, platelets and fresh frozen plasma. After that, all of her blood test results returned to normal levels including coagulation tests concomitent with resolving symptoms. In that there were no proof of underlying diseases that can cause vitamin K deficiency, she was diagnosed as idiopathic transient vitamin K deficiency.

Evaluation of risk factors in patients with vitamin K-dependent coagulopathy presumed to be caused by exposure to brodifacoum

BACKGROUND/AIMS: Recently, many cases of vitamin K-dependent coagulopathy of unknown origin have been reported. Such patients lack any relevant family history and have no systemic disease, raising suspicion of superwarfarin intoxication. We evaluated individual risk factors causing coagulopathy and hemorrhagic symptoms in patients with suspected superwarfarin intoxication. In addition, we determined how to effectively treat vitamin K-dependent coagulopathy caused by suspected superwarfarin intoxication. METHODS: Seven patients with suspected superwarfarin intoxication who lacked any definitive history of rodenticide ingestion were included. Thirty-one patients initially diagnosed with rodenticide poisoning were also included. We performed a retrospective chart review of all subjects and examined clinical data including patient demographics and medical histories. RESULTS: Patients initially diagnosed with rodenticide poisoning were divided into two groups, one of which had a laboratory abnormality (prothrombin time [PT] > 13 seconds) and another group with PTs in the normal range. There was no significant difference between the two groups in any of age, gender, the extent of chronic alcohol consumption, the causative rodenticide, psychiatric problems, ingestion of drugs interacting with warfarin, the extent of intoxication, or the type of ingestion attempt. The albumin level of the former group was significantly lower than that of the latter group (p = 0.014). Furthermore, a significant difference between the two groups was evident in terms of simultaneous ingestion of rodenticide and alcohol (p = 0.023). CONCLUSIONS: Most patients with superwarfarin poisoning did not exhibit any complication. When such complications were evident, they were associated with serum albumin level and coingestion of rodenticide and alcohol.

Intravenous administration of vitamin K as an effective treatment for a patient with systemic hemorrhage: a case report

A man in his 60s, who was diagnosed as having postoperative recurrent gastric cancer with lymph node and spinal metastases, was admitted to our palliative care unit (PCU). He was unable to receive further aggressive chemotherapy for cancer because of bilateral hydronephrosis and chronic renal failure. He had chronic urethral infection and hence required continuous antibiotic administration. Although his infection was well controlled with antibiotics, his oral intake gradually declined. Seventeen days after admission, he developed systemic hemorrhage, including hematuria and oral bleeding. Coagulation tests revealed that the patient had markedly prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT) but no thrombocytopenia, fibrinogen consumption, or increased fibrin/fibrinogen degradation products (FDP) level. Serum level of protein induced by vitamin K absence or antagonist II (PIVKA-II) was markedly high, and vitamin K level was below the lower limit of the reference range. After he was administered intravenous vitamin K, his symptoms markedly improved. Many patients with advanced cancers tend to have malnutrition, anorexia, and chronic infection that require antibiotic administration. Prophylactic administration of vitamin K might be sometimes necessary for preventing catastrophic hemorrhage.

Clinical analysis of 12 patients caused by long-acting anticoagulant rodenticide occult poisoning / 中南大学学报(医学版)

Objective:To explore the clinical characteristics and diagnosis and treatment of occult poisoning caused by long-acting anticoagulant rodenticides.Method:Records of 12 patients from July 2008 to April 2011 diagnosed as anticoagulant rodenticide occult poisoning,who had been misdiagnosed initially at other hospitals were analyzed retrospectively.Elements from the records included clinical symptoms and signs,laboratory findings for prothrombin time (PT) and activated partial prothrombin time (APTT),and initial misdiagnosis and treatment outcome at our hospital.Results:The clinical presentations of patients were insidious and serious,often presented as skin ecchymose,hematuria,menorrhagia and gastrointestine bleeding.Laboratory examinations showed prolonged PT and APTT; bleeding was controlled effectively by administoring vitamin K1 daily.There were statistical difference between PT and APTT before and after the treatment (P＜0.01).Conclusion:Coagulation disorders might be caused by the reduced acquisition in vitamin K dependent coagulation factors,which tends to be neglected due to a hidden medical history,delayed signs of poisoning,and various organs involved.A detailed patient history and systematic review may improve the diagnostic accuracy.Once diagnosed is made,vitamin K1 should be given as soon as possible.

Hemorragia intracraneal como forma de presentación de atresia biliar: presentación de dos casos / Intracranial hemorrhage as initial presentation of biliary atresia: two cases report

La atresia biliar en lactantes se presenta habitualmente con la tríada ictericia, acolia y coluria, y ocasionalmente con sangrado intracraneal, nasal o gastrointestinal. Presentamos dos niñas, de cuatro y dos meses, que fueron asistidas por presentar convulsiones, cefalohematoma y sopor. En la tomografía computada cerebral se halló hemorragia subdural en una paciente e intraventricular y parenquimatosa en la otra. Al ingreso, presentaban antecedentes, signos clínicos y de laboratorio de colestasis, sin diagnóstico etiológico. La niña con hematoma subdural requirió drenaje quirúrgico. La paciente con sangrado intraventricular y parenquimatoso no requirió cirugía y se le administró vitamina K. Se diagnosticó atresia de vías biliares mediante centellograma con HIDA y colangiografía intraoperatoria previa al procedimiento de Kasai (portoenteroanastomosis). Ambas niñas presentaron buena evolución neurológica a los seis meses. Requirieron trasplante de hígado alrededor del año de vida. La atresia biliar se debe considerar en el diagnóstico de lactantes pequeños que presentan sangrado agudo y colestasis.

Biliary atresia in infants occasionally presents as intracranial, nasal or gastrointestinal bleeding, instead of the classical triad of jaundice, acholia and choluria. We present two female infants aged four and two months, who were hospitalized with convulsive episode, cephalohematoma and drowsiness. Computed tomography fndings were subdural hemorrhage in one patient and intraventricular and parenchymal bleeding in the other one. At admission they have history, clinical and laboratory signs of cholestasis of unknown etiology. The patient with subdural hemorrhage required surgical drainage. The other girl with intraventricular and parenchymal bleeding received vitamin K and no surgery. Biliary atresia was diagnosed and treated in both girls. At six months both had an adequate neurological outcome and required liver transplantation at one year old. Biliary atresia should be considered in all infants with sudden acute bleeding and cholestasis.

Analysis of the cinical features and misdiagnosis in 62 patients with acquired deficiency of vitamin Kdependent coagulation factors / 中国综合临床

Objective To explore the clinical features and causes of misdiagnosis of the patients with acquired deficiency of vitamin K-dependent coagulation factors (ADVKDCF). Methods Retrospective analysis was performed with the data from 62 patients with ADVKDCF for etiological factors, clinical manifestations,laboratory examinations, diagnosis and treatments. Results Among the 62 patients, 51 patients were with unknown causes( subgroup A) and 11 were with clear histories of anticoagulant rodenticide poisoning( subgroup B). The presentations of hemorrhage of the patients varied with hematuria as the most common first symptom,followed by skin, mucosa, muscle, internal organs bleeding (28/62). The most common hemorrhage symptom is hematuria. 35 of the 62 patients had hemoglobin(Hb) levels less than 100 g/L due to blood loss( the lowest level was 32 g/L). Thirty-eight patients were misdiagnosed at the first visit and the median time from hemorrhage manifestation to definite diagnosis was 8 days (range,2 to 192 days). ADVKDCF was mostly misdiagnosed as the urinary system diseases (23/38), followed by hemophilia (8/38). Laboratory examinations showed normal platelet count , throm bin time (TT) and normal fibrinogen(Fg) concentration, but prolonged plasma prothrombin time (PT), activated partial prothrombin time (APTT) and international normalized ration (INR). All of patients received high dose vitamin K ( intravenous vitamin K1 with a initial dose of 20 to 240 mg/d and then oral vitamin K4 maintenance) . The bleeding symptoms disappeared 1 day after treatment and the Hb levels increased dramatically. There were significant differences in PT, APTT and INR of the patients before and after treatment( P ＜0. 01 ). Followed by a median follow - up of 8 months , no patient had severe adverse effects or recurrence. Conclusion The hemorrhage presentations of the patients with ADVKDCF are various. The most common hemorrhage symptom is hematuria. The misdiagnosis rate of ADVKDCF is high with urinary systems disorders as the most common misdiagnosis. Sequential treatment with vitamin K is an effective and safe method to prevent recurrence. Early detection of coagulation function is helpful to reduce misdiagnosis possibility.

Risk Factors for Intracranial Hemorrhage Caused by Late Vitamin K Deficiency / 实用儿科临床杂志

Objective To explore the risk factors for intracranial hemorrhage caused by late vitamin K deficiency bleeding(VKDB),in order to prevent and reduce the incidence of intracranial hemorrhage caused by late VKDB.Methods A retrospective analysis of the risk factors of late VKDB and intracranial hemorrhage was applied to 2 groups of patients in PICU and department of neurology of Beijing children's Hospital from Jan.2002 to Dec.2007.In group Ⅰ,there were 90 patients suffering from intracranial hemorrhage caused by late VKDB;while in group Ⅱ,there were 23 patients of late VKDB without intracranial hemorrhage.Within 12 hours of hospitalization,the following 9 items were checked:the cranial CT,blood calcium concentration,liver function,serum sodium,blood glucose,prothrombin time,partial thromboplastin time,fibrinogen concentration,and platelet.Ten possible relevant risk factors of gender,age,birth situation,feeding patterns,recent diarrhea,cytomegalovirus(CMV)infection,hypocalcemia,dysglycemia,hyponatremia,and abnormal liver function were analyzed by the method of non-conditional Logistic regression analysis.Results Statistically significant difference had been found in the 3 factors of hypocalcaemia,recent diarrhea,abnormal liver function(Pa

Inherited Vitamin K Deficiency: Case Report and Review of Literature

Vitamin K is the cofactor for the hepatic carboxylation of glutamic acid residues in a number of proteins including the procoagulants factors ll, Vll, lX, and X. The role of vitamin K in normal bone function is not fully understood. Inherited deficiency of vitamin K dependent coagulation factors is a rare bleeding disorder reported only in a few patients. Here we present an 18-month old child who presented with osteopeni due to inherited vitamin K deficiency. While the patient had high bone specific alkaline phosphatase and parathyroid hormone levels and low osteocalcin and bone mineral density values, with the regular supplementation of vitamin K all the mentioned parameters returned to normal values.

Clinical analysis and prevention of 36 cases of delayed vitamin K deficiancy / 重庆医科大学学报

Objective:To explore the clinical feature and prevention of delayed vitamin K deficiency in infants.Methods:The clinical data of 36 infants with delayed vitamin K deficiency who had been admitted to paediatric ward in our hospital during the last 4 years were analyzed retrospectively.Results:28 cases were cured with a cure rate of 77.78%;5 cases died with a mortality rate of13.89%;3 cases gave up treatment which accounts for 8.33%.Conclusion:The incidence rate of delayed vitamin K deficiency is high in infants on pure breastfeeding,and it could be prevented by periodical administration of supplementary vitamin K_1 in small doses to all infants from birth to 3 months.The early diagnosis and proper treatment of delayed vitamin K deficiency are of much clinical significance in increasing cure rate and reducing mortality rate.