Case of toluene abuse

Abstract

Haemorrhagic disease of the newborn (HDN) can be defined as vitamin K deficiency related bleeding. HDN is one of the most frequent bleeding disorders in infancy [1]. It is classified as early, classical and late - onset disease according to the time bleeding occurs. Early HDN is diagnosed when the bleeding begins in the first 24 hours of postnatal period. It is frequently seen in babies whose mothers are on antitubercular (isoniazid and/or rifampicin), or antiepileptic (such as phenytoin and phenobarbitol) drugs. Classical HDN occurs between 2-5 days of neonatal period and life-threatening bleeding is rare. Late-onset disease can be seen during infancy but predominantly at 4-8 weeks of life. Its incidence is 4-25/1,00,000 births in the western countries but as high as 25-80/1,00,000 in eastern countries [2]. Late haemorrhagic disease is diagnosed if bleeding occurring after the 7th day of life with normal platelet count, prolonged prothrombin time (PT) and partial thromboplastin time (PTT) associated with stopping of bleeding and PT/PTT returning to normal after giving vitamin K [3].