No abstract available.
4-Hydroxycoumarins/*poisoning ; Anticoagulants/*poisoning ; Blood Coagulation/*drug effects ; Female ; Humans ; Male ; Rodenticides/*poisoning ; Vitamin K/*blood ; Vitamin K Deficiency Bleeding/*chemically induced

Adolescent ; Adult ; Aged ; Blood Coagulation Disorders ; Blood Coagulation Factors ; Case-Control Studies ; Child ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vitamin K ; Vitamin K Deficiency ; Young Adult

PURPOSE: Vitamin K deficiency is associated with hemorrhagic disease of the newborn. Late hemorrhagic disease is often intracranial and may be fatal. Many countries recommend vitamin K prophylaxis after birth to prevent this hazard of vitamin K deficiency. Nevertheless, there are still controversies concerning the best way of providing effective prophylaxis. A recent article by Golding and colleagues has questioned the safety of the routine use of intramuscular vitamin K for the newborn. These authors reported a significantly increased rate of childhood cancer in infants who received intramuscular prophylaxis. So we compared the prophylactic effect of intramuscular, oral, and maternal administration of vitamin K on hemorrhagic disease of the newborn. METHODS: A total of 60 newborns, delivered spontaneously vaginally, in the Masan Fatima hospital from March to June, 1996, were enrolled. Neonated with intrapartum anoxia, liver disease or hereditary coagulation factor deficiencies, who received antibiotics were excluded. Mothers receiving any medication known to interferes with vitamin K metabolism(such as antiepileptics, antibiotics and anticonvulsions) were excluded. The newborns were randomly allocated to one of the four groups. A group was not supplied. B group received 1mg of vitamin K1 intramusculary, C group received 2mg of vitamin K1 orally. D group was given 20mg of vitamin K1 orally to their mothers at least 2days(range 2 to 7) before birth. Blood samples were collected from 48hrs to 72hrs after birth. PIVKA-II level was measured by enzyme-linked immunosorbent assay (EITEST-MONOP, Eisai Ltd), using a monospecific monoclonal antibody against PIVKA-II. The results obtained are expressed in arbitrary unit (AU) : 1AU corresponds to 1micro gram of purified prothrombin. (healthy adults have less than 0.13AU/ml). PT, PTT were measured simultaneously. RESULTS: 1) PIVKA-II was detected in 4 of 15 infants in group A, who were not supplied. None was detected in other groups. So PIVKA-II detection rate was significantly decreased in other groups compared with group A(p<0.05). 2) PT(sec) values were 12.74+/-0.91, 12.58+/-0.89, 12.36+/-1.04, 12.16+/-0.90 respectively, and there was no significant difference between groups. 3) PTT(sec) values were 52.41+/-13.26, 38.39+/-10.04, 42.67+/-7.01, 39.77+/-10.48 respectively and there was significant shortening in other groups compared with group A (p<0.05). CONCLUSION: Not only intramuscular administration but oral and maternal administration of vitamin K have prophylactic effect on hemorrhagic disease of the newborn. Prophylactic effect on the late hemorragic disease of the newborn requires further extensive study and evaluation.
Adult ; Anoxia ; Anti-Bacterial Agents ; Anticonvulsants ; Blood Coagulation Factors ; Enzyme-Linked Immunosorbent Assay ; Humans ; Infant ; Infant, Newborn* ; Liver Diseases ; Mothers ; Parturition ; Prothrombin ; Vitamin K 1 ; Vitamin K Deficiency ; Vitamin K* ; Vitamins*

We had reviewed the cases 8 thirteen patients with intracranial hemorrhage secondary to vitamine K deficiency, admitted between March 1990 at February 1994. The results were as follows: 1) The most common age of onset was under 2 months(12 cases, 92.3%). Sex ratio between male and female was 3.3:1(10:3). Premature was one of all cases. 2) In feeding history, breast feeding(7 cases, 53.8%) was most common, followed by mixed feeding(4 cases, 30.8%) and formular feeding(2 cases, 15.4%). Breast feeding, with or without formula, constituted 11 cases (84.6%) and intracranial hemorrhage was developed in breast feeded babies often more than in formular feeded ones. 3) Clinical findings were variable: mental change(11 cases, 84%) was the most common feature, followed by irritability, poor sucking, vomiting, motor weakness and poor crying. 4) Subdural hemorrhage(9 cases, 69.2%) was most common and followed by intracerebral hemorrhage(7 cases, 53.9%) and intraventricular hemorrhage(3 cases, 23.1%), with or without other hemorrahge. 5) Prolongation of PT and vitamine K dependent coagulation factor deficiencies were noted in all cases. APTT was prolonged in 11 cases(84.6%), but it returned to normal in all cases after vitamine K administration. Vitamine k1 level checked in 5 cases was lower than normal. 6) Treatment included vitamine K administration, subdural tap, burr hole drainage, EVD or craniotomy. Short term result was not good(grade IV+V;8 cases(61.8%)), but long term outcome would be worse than short term outcome(normal ; 1 case). It is our believe that while not very common in Western nations.
Age of Onset ; Blood Coagulation Factors ; Breast ; Breast Feeding ; Craniotomy ; Crying ; Drainage ; Female ; Humans ; Infant* ; Intracranial Hemorrhages* ; Male ; Sex Ratio ; Vitamin K Deficiency* ; Vitamin K* ; Vitamins* ; Vomiting

Intracerebral hemorrhage secondary to vitamin K deficiency is presented in three newborn infants: 4 days, 28 days and 21 days of age respectively. After the administration of vitamin K(5-10 mg) either intravenously or intramusculary, prolonged prothrombin time(PT) and partial thromboplastin time(PTT) were corrected promptly. Vitamin K dependent coagulation factor deficiency due to vitamin K deficiency is accounted for the pathogenesis of hemorrhage. The possible causes of vitamin K deficiency, diagnostic methods and treatment of this disease entity are reviewed. Neurosurgeons as well as pediatricians should remain alert for the development of intracerebral hemorrhage caused by vitamin K deficiency in neonatal period.
Blood Coagulation Factors ; Cerebral Hemorrhage* ; Hemorrhage ; Humans ; Infant, Newborn* ; Partial Thromboplastin Time ; Prothrombin ; Prothrombin Time ; Thromboplastin ; Vitamin K Deficiency* ; Vitamin K* ; Vitamins*

A hemorrhagic disease due to acquired prothrombin complex deficiency is presented in five infants from 3 weeks to 2 months of age. There are 2 cases of intracranial hemorrhage, 1 case of hemothorax, 2 cases of gastrointestinal bleeding, 1 case of epistaxis and 3 cases of petechia, purpura or bleeding from injection site. After the administration of vitamin K, bleeding ceased and prolonged prothrombin time was corrected promptly. Vitamin K dependent coagulation factor deficiency due to vitamin K deficiency is accounted for the pathogenesis of bleeding. Diarrhea, treatment with antimicrobial agents and a diet low in vitamin K are suggested as etiologic factors acting together.
Anti-Infective Agents ; Blood Coagulation Factors ; Diarrhea ; Diet ; Epistaxis ; Hemorrhage ; Hemothorax ; Humans ; Infant ; Intracranial Hemorrhages ; Osteopetrosis ; Prothrombin ; Prothrombin Time ; Purpura ; Vitamin K ; Vitamin K Deficiency

A hemorrhagic disease due to acquired prothrombin complex deficiency is presented in five infants from 3 weeks to 2 months of age. There are 2 cases of intracranial hemorrhage, 1 case of hemothorax, 2 cases of gastrointestinal bleeding, 1 case of epistaxis and 3 cases of petechia, purpura or bleeding from injection site. After the administration of vitamin K, bleeding ceased and prolonged prothrombin time was corrected promptly. Vitamin K dependent coagulation factor deficiency due to vitamin K deficiency is accounted for the pathogenesis of bleeding. Diarrhea, treatment with antimicrobial agents and a diet low in vitamin K are suggested as etiologic factors acting together.
Anti-Infective Agents ; Blood Coagulation Factors ; Diarrhea ; Diet ; Epistaxis ; Hemorrhage ; Hemothorax ; Humans ; Infant ; Intracranial Hemorrhages ; Osteopetrosis ; Prothrombin ; Prothrombin Time ; Purpura ; Vitamin K ; Vitamin K Deficiency

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.
Bone Density ; Bone Diseases, Metabolic/etiology ; Human ; Infant ; Male ; Osteocalcin/blood ; Prothrombin Time ; Vitamin K Deficiency/blood/complications/*genetics

Congenital combined deficiency of vitamin K dependent coagulation factors is a rare coagulation disorder. We experienced a 20-month old boy who was found to have a congenital vitamin K dependent coagulation factor defeciency. He presented with continuous bleeding on lacerated hard palate and had a history of numerous hemorrhagic episodes with multiple bruises after birth. Laboratory finding showed prolonged prothrombin time and partial thromboplastin time. Blood coagulation work-up showed marked decreased activities of the coagulation factors II, VII, IX, X and the natural anticoagulants proteins C and S. Assay of coagulation factors in the parents and sibling were with the normal range. There's no evidence of malabsorption, liver disease or ingestion of a coumarin compound. Response to intravenous administration of vitamin K1 was not significant but transfusion of fresh frozen plasma corrected prothrombin time and partial thromboplastin time. We reported a case of congenital combined deficiency of vitamin K dependent coagulation factors.
Administration, Intravenous ; Anticoagulants ; Blood Coagulation ; Blood Coagulation Factors ; Contusions ; Eating ; Hemorrhage ; Humans ; Infant ; Liver Diseases ; Male ; Palate, Hard ; Parents ; Partial Thromboplastin Time ; Parturition ; Plasma ; Prothrombin Time ; Reference Values ; Siblings ; Vitamin K 1 ; Vitamin K* ; Vitamins*

A cardiovascular collapse, due to preoperatively administered intravenous vitamin K (phytonadione), was experienced in a 59-year-old woman who was scheduled to undergo a left upper lung lobectomy. The patient developed sudden facial flushing, an upper torso rash, dyspnea, palpitation, and severe hypotension about 2 min after the intravenous administration of approximately 2 mg of vitamin K. Immediate hydration and an injection of 20 mg ephedrine restored her blood pressure to the preoperative level within 5 min. The patient recovered without any sequelae, but the operation was postponed. The patient's symptoms seemed to be due to an anaphylactoid reaction or anaphylaxis following the intravenous administration of vitamin K. This case report suggests that physicians should carefully review the indications of vitamin K prior to administration, even at low doses.
Administration, Intravenous ; Anaphylaxis ; Blood Pressure ; Dyspnea ; Ephedrine ; Exanthema ; Female ; Flushing ; Humans ; Hypotension ; Lung ; Middle Aged ; Torso ; Vitamin K ; Vitamins*