Moderate Hemophilia B Diagnosed by Massive Gastrointestinal Hemorrhage on the First Day of Life: A Case Report and Literature Review

ABSTRACT

Gastrointestinal hemorrhage in neonates is commonly associated with necrotizing enterocolitis, cow's milk protein allergy, and gastrointestinal malformation. Gastrointestinal bleeding on the first day of life, presenting as the first manifestation of a disorder, has rarely been reported associations with gastric ulceration, Salmonella infection, and allergic colitis. Hemophilia B is also a rare cause of gastrointestinal bleeding during the neonatal period. In the present case, a male infant developed repetitive hematemesis on the first day of life. His initial level of coagulation factor IX was 1.9%, and he was diagnosed with moderate hemophilia B. No further hematemesis or melena was observed during recombinant factor IX therapy. The infant did not have a family history of hemophilia. In conclusion, although gastrointestinal hemorrhage on the first day of life as the first manifestation of a disease is rare, infants who present with spontaneous gastrointestinal hemorrhage after birth and with unexplained prolonged activated partial thromboplastin time should be evaluated for coagulation factor deficiency regardless of whether they have any family history of hemophilia.