Clinical features
The clinical picture of the disease is non-specific. Bruising is common, spontaneous haemorrhage is rare and surgical bleeding is increased. Features linked to the stages of Vitamin K deficiency bleeding (VKDB) include: (1)
- Early VKDB.
Presents with bleeding at sites related to the trauma of birth, such as the scalp monitor site and cephalhaematomas following a ventouse delivery.
- Classic VKDB
Typically presents as bleeding from organs, such as the gut, skin or mucous membranes and also bleeding from the umbilical stump.
- Late VKDB
Peaks at 3-8 weeks old and typically presents with intracranial haemorrhage and is often caused by undiagnosed cholestasis with resultant malabsorption of vitamin K.6. Late VKDB causes the greatest risk of death due to sudden bleeding into the central nervous system. (2)
References
- Marchili MR, Santoro E, Marchesi A, et al. Vitamin K deficiency: a case report and review of current guidelines. Ital J Pediatr. 2018 Mar 14;44(1):36
- Elalfy MS, Elagouza IA, Ibrahim FA, et al. Intracranial haemorrhage is linked to late onset vitamin K deficiency in infants aged 2-24 weeks. Acta Paediatr. 2014 Jun;103(6)
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