Abstract
BackgroundVitamin K, a fat soluble vitamin, is a necessary cofactor for the activation of coagulation factors II, VII, IX, X, and protein C and S. In neonatal period, vitamin K deficiency may lead to Vitamin K Deficiency Bleeding (VKDB).Case presentationWe present the case of a 2 months and 20 days Caucasian male, presented for bleeding from the injections sites of vaccines. At birth oral vitamin K prophylaxis was administered. Neonatal period was normal. He was exclusively breastfed and received a daily oral supplementation with 25 μg of vitamin K. A late onset vitamin K deficiency bleeding was suspected. Intravenous Vitamin K was administered with complete recovery.ConclusionsNevertheless the oral prophylaxis, our case developed a VKDB: it is necessary to revise the current guidelines in order to standardize timing and dosage in different clinical conditions.
Highlights
Vitamin K, a fat soluble vitamin, is a necessary cofactor for the activation of coagulation factors II, VII, IX, X, and protein C and S
These recommendations are based on the evidence that intramuscular administration of vitamin K is clinically more effective than oral administration, and that multiple oral doses of Vitamin K are necessary to obtain adequate protection against the late Vitamin K Deficiency Bleeding (VKDB) onset in breastfed children [12, 13]
If intramuscular administration is rejected by parents, the administration of multiple oral doses is recommended as a second option
Summary
Vitamin K, a fat soluble vitamin, is a necessary cofactor for the activation of coagulation factors II, VII, IX, X, and protein C and S. Case presentation We reported the case of a 2 months and 20 days white Caucasian male, presented for bleeding from the injections sites of the first dose of hexavalent and pneumococcal vaccine He was born from unrelated parents at 41 weeks of gestational age by urgent cesarean section, with a birth weight of 3200 kg and a 5-min Apgar score of 10. He was exclusively breastfed and he received a daily supplementation of 25 μg of vitamin K and 400 IU of vitamin D. On the anterior region of both thighs, the injection sites of vaccines were recognizable, with a slight bleeding from the injection site on the left leg, without signs of edema He had a normal cardiorespiratory activity and normal vital signs (blood pressure 70/46 mmHg, heart rate 126 bpm, respiratory rate 30 acts/min, body temperature 36 °C). Considering the low hemoglobin values, he was transfused without any adverse reaction
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