Late-onset vitamin K deficiency presenting as haemorrhagic shock and severe multi-system organ failure.

Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE

Original Publication: London : BMJ Pub. Group

Multiple Organ Failure*/etiology ; Vitamin K Deficiency*/complications ; Shock, Hemorrhagic*/etiology ; Vitamin K*/therapeutic use ; Vitamin K*/administration & dosage; Humans ; Male ; Infant ; Breast Feeding ; Vitamin K Deficiency Bleeding/diagnosis ; Injections, Intramuscular ; Treatment Refusal

Vitamin K is an essential dietary cofactor required for the synthesis of active forms of vitamin K-dependent procoagulant proteins. Vitamin K deficiency, particularly late-onset deficiency occurring between 1 week and 6 months of age, can cause a life-threatening bleeding disorder. An exclusively breastfed, full-term, 6-week-old infant male presented with severe haemorrhagic shock and multi-system organ failure related to caregiver refusal of intramuscular vitamin K after birth. Coagulation studies were normalised within 8 hours of intramuscular vitamin K administration. An increasing number of caregivers are refusing intramuscular vitamin K which has led to a rise in the incidence of vitamin K deficiency bleeding. Health policy organisations around the world emphasise the benefits of intramuscular vitamin K and risks of refusal, particularly in exclusively breastfed infants who are at higher risk due to low vitamin K levels in breast milk. This case highlights the multi-system severity of this life-threatening yet preventable disorder.
Competing Interests: Competing interests: None declared.
(© BMJ Publishing Group Limited 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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Keywords: Haematology (incl blood transfusion); Infant health; Neonatal and paediatric intensive care; Preventative pediatrics; Routine care of the full-time infant

12001-79-5 (Vitamin K)

Date Created: 20240809 Date Completed: 20240809 Latest Revision: 20240920

20240920

PMC11409245

10.1136/bcr-2024-261126

39122381