Vitamin K Deficiency After the Newborn Period

"Another lesson" not mentioned by Drs. Goldman and Amadio,1 yet confirmed in their report, is that the routine use of antibiotics for diarrheal disease in most pediatric populations in our country, without prior bacteriological confirmation, may be fraught with profound consequences and should be discouraged.

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INTRACRANIAL HEMORRHAGE DUE TO VITAMIN K DEFICIENCY AFTER THE NEWBORN PERIOD

Pediatric Hematology and Oncology ◽

10.1080/08880010490500944 ◽

2004 ◽

Vol 21 (7) ◽

pp. 585-592 ◽

Cited By ~ 12

Author(s):

Kaan Demirören ◽

Haluk Yavuz ◽

Lokman Çam

Keyword(s):

Intracranial Hemorrhage ◽

Vitamin K ◽

Vitamin K Deficiency ◽

Newborn Period ◽

K Deficiency

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Vitamin K Deficiency After the Newborn Period

PEDIATRICS ◽

10.1542/peds.44.5.745 ◽

1969 ◽

Vol 44 (5) ◽

pp. 745-749

Author(s):

Herbert I. Goldman ◽

Peter Amadio

Keyword(s):

Vitamin K ◽

Vitamin K1 ◽

Milk Diet ◽

Vitamin K Deficiency ◽

Oral Vitamin ◽

Newborn Period ◽

Single Episode ◽

Supplemental Vitamin ◽

K Deficiency ◽

Bleeding Episodes

Sixty infants, 1 to 18 months of age, with diarrhea, were treated with a skimmed milk diet and succinylfathiazole. Thirty received supplemental vitamin K1 and had oral vitamin K intakes, expressed as K1 activity, of 16.1 to 36.3 µg/kg/day. Hypoprothrombinemia was not observed. Thirty did not receive supplementation and had intakes, similarly expressed, of 9.2 to 29.5 µg/kg/day. A single episode of hypoprothrombinemia was recorded on an intake of 9.8 µg/kg/day. In a group of 15 infants with clinical bleeding episodes due to vitamin K deficiency, the oral vitamin K intakes, expressed as K1 activity, were 0.0 to 8.4 µg/kg/day. These data suggest that, in infants who have diarrhea and/or are receiving antimicrobials, there exists a risk of vitamin K deficiency if the dietary intake contains less than the approximate equivalent of 10 µg/kg/day of vitamin K1 activity.

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Vitamin K Deficiency and So-called Nodular Purpura in Infancy

PEDIATRICS ◽

10.1542/peds.45.5.891a ◽

1970 ◽

Vol 45 (5) ◽

pp. 891-892

Author(s):

G. R. Burgio ◽

R. Vaccaro

Keyword(s):

Dietary Intake ◽

Vitamin K ◽

Clinical Condition ◽

Vitamin K Deficiency ◽

Newborn Period ◽

Vitamin K Deficiency Bleeding ◽

K Deficiency

Goldman and Amadio (Pediatrics, 44:745, 1969) recently reviewed 15 cases (including 3 not previously published) of "vitamin K deficiency bleeding after the newborn period" and attributed the cause of this deficiency to a low dietary intake of vitamin K and low intestinal supply. We would like to point out that the same factors have been considered for a clinical condition of vitamin K deficiency after the newborn period, indicated as "nodular purpura in infancy." This definition was suggested by the presence of hemorrhagic infiltrations on the skin.

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Placental Transfer of Vitamin K1 and Its Implications in Fetal Hemostasis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647631 ◽

1988 ◽

Vol 60 (01) ◽

pp. 039-043 ◽

Cited By ~ 52

Author(s):

L Mandelbrot ◽

M Guillaumont ◽

M Leclercq ◽

J J Lefrère ◽

D Gozin ◽

...

Keyword(s):

Vitamin K ◽

High Performance ◽

Ultrasound Guidance ◽

Placental Transfer ◽

Vitamin K1 ◽

Vitamin K Deficiency ◽

Prothrombin Activity ◽

Oral Supplementation ◽

K Deficiency ◽

The Mean

SummaryVitamin K status was evaluated using coagulation studies and/ or vitamin IQ assays in a total of 53 normal fetuses and 47 neonates. Second trimester fetal blood samples were obtained for prenatal diagnosis under ultrasound guidance. Endogenous vitamin K1 concentrations (determined by high performance liquid chromatography) were substantially lower than maternal levels. The mean maternal-fetal gradient was 14-fold at mid trimester and 18-fold at birth. Despite low vitamin K levels, descarboxy prothrombin, detected by a staphylocoagulase assay, was elevated in only a single fetus and a single neonate.After maternal oral supplementation with vitamin K1, cord vitamin K1 levels were boosted 30-fold at mid trimester and 60 fold at term, demonstrating placental transfer. However, these levels were substantially lower than corresponding supplemented maternal levels. Despite elevated vitamin K1 concentrations, supplemented fetuses and neonates showed no increase in total or coagulant prothrombin activity. These results suggest that the low prothrombin levels found during intrauterine life are not due to vitamin K deficiency.

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Kinetic Aspects of the Interaction of Blood-Clotting Enzymes

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651250 ◽

1968 ◽

Vol 20 (01/02) ◽

pp. 078-087 ◽

Cited By ~ 34

Author(s):

H. C Hemker ◽

A. D Muller

Keyword(s):

Vitamin K ◽

Blood Clotting ◽

Experimental Results ◽

Factor X ◽

Clotting Factors ◽

Vitamin K Deficiency ◽

K Deficiency

SummaryPIVKA, the circulating anticoagulant protein found in vitamin K deficiency can, on kinetical grounds, be recognized as an analogue of factor X. The existence of analogues of other vitamin K-dependent clotting factors cannot be ruled out, but need not be assumed to explain the experimental results.

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