Late Vitamin Research Articles

Intracranial haemorrhage due to late onset vitamin K deficiency bleeding in Hanoi province, Vietnam

Background: In many developing countries vitamin K prophylaxis is not routinely administered at birth. There are insufficient data to assess the cost effectiveness of its implementation in such countries. Objective:...

Acquired bleeding disorders: the impact of health problems in the developing world.

Several acquired bleeding disorders in the developing world have impacts on health, including late vitamin K deficiency bleeding (VKDB) in infants, dengue haemorrhagic fever (DHF), and malaria. This paper describes their clinical manifestations, mechanisms involved, and treatment.

Intestinal absorption of mixed micellar phylloquinone (vitamin K1) is unreliable in infants with conjugated hyperbilirubinaemia: implications for oral prophylaxis of vitamin K deficiency bleeding

Objective: To compare the pharmacokinetics and efficacy of oral versus intravenous mixed micellar vitamin K prophylaxis in infants with cholestatic liver disease, a known risk factor for vitamin K deficiency...

Effects of oral vitamin E supplementation during late gestation in beef cattle that calved in late winter and late summer.

To determine effects of breed and oral vitamin E supplementation during late gestation on serum vitamin E and IgG concentrations in beef cows that calved in late winter and late summer and in neonatal calves. 73 Angus and 43 Hereford primiparous and multiparous cows and their calves. Cows in groups that were homogeneous regarding breed and age distribution were randomly allotted to groups that were orally supplemented (n = 59) or not supplemented (57) with vitamin E beginning 30 days prior to onset of 65-day calving seasons. Supplemental vitamin E was provided in a vitamin-mineral mix offered free-choice until parturition. Cows that calved in late winter and were supplemented orally with vitamin E had higher serum vitamin E concentrations at calving and after calving than did unsupplemented cows; differences between groups before calving were not significant. Calves from supplemented multiparous cows had higher vitamin E concentrations than did calves from unsupplemented cows. Winter-born calves from supplemented Hereford cows had heavier 205-day adjusted weaning weights than did winter-born calves from unsupplemented Hereford cows. Supplementation did not affect vitamin E or IgG concentrations in the herd that calved in late summer and did not affect calf growth. Oral vitamin E supplementation during late gestation may be economically beneficial in certain cow-calf operations in which late-gestation cows are consuming stored forages.

Six years' experience of prophylactic oral vitamin K

AIMSThe ability of oral vitamin K to eliminate all risk of vitamin K deficiency bleeding during the first three months of life was studied.METHODSBabies (n=182 000) in the north of...

Oral vitamin K1 prophylaxis for newborns with a new mixed-micellar preparation of phylloquinone: 3 years experience in Switzerland.

In 1995, a new water-soluble mixed-micellar analogue of vitamin K1 (Konakion MM paediatric) was introduced in Switzerland to replace the formerly used fat-soluble Konakion drops for the prevention of vitamin K1-deficiency-bleeding (VKDB) in infants. According to the new guidelines, an oral dose of 2 mg is given after birth and again on the 4th day of life. We examined the compliance with these guidelines and the impact on the incidence of VKDB. To assess compliance, questionnaires were sent to all hospitals with delivery services 6 months after the introduction of the new guidelines. Using the database of the Swiss Paediatric Surveillance Unit (SPSU) which records rare paediatric diseases, we assessed the incidence of VKDB in Switzerland between July 1995 and June 1998. In addition, we determined the precise circumstances under which the episodes of VKDB occurred. More than 99% of infants received vitamin K1 prophylaxis. Since July 1995, 93% of newborns have received prophylaxis according to the new guidelines; the remaining infants were given fat-soluble Konakion drops or parenteral vitamin K1. Within 3 years, one case of classical and 12 cases of late-onset VKDB (11 confirmed, 1 probable) were reported to the SPSU. Of the 11 confirmed late-onset cases, 7 received the recommended prophylaxis, whereas 3 had not and 1 had been given fat-soluble Konakion drops. All confirmed cases of late-onset VKDB occurred in fully breast-fed infants and 8 of 11 had hepatobiliary disease. With the introduction of two oral doses of a mixed-micellar vitamin K1 preparation administered in the 1st week of life, the incidence of late vitamin K1-deficiency-bleeding has decreased from 7.2:100,000 between 1986-1987 to 2.8:100,000 between 1995 and 1998. This regimen may be suitable for prophylaxis of vitamin K1-deficiency-bleeding, however, it does not fully protect infants with cholestatic disease from late-onset bleeding. If oral prophylaxis is considered for these infants, vitamin K1 has to be administered repeatedly to all infants during the breast feeding period.

Late hemorragic disease of the newborn: case report

OBJECTIVE: In this study the authors review this subject, and call attention for the late hemorrhagic disease of the newborn, due to the severity and higher risk of mortality and neurological sequelae.METHODS: In this article, four cases of children, age raging from 12 to 21 days, with late hemorrhagic disease associated with vitamin K deficiency were reported. RESULTS: All newborns had multiple hemorrhagic manifestations of the disease. The systems more affected were digestive tract, urinary system, umbilical cord, respiratory system and nervous system.CONCLUSION: Three forms of hemorrhagic disease of newborn have been related with vitamin K deficiency. However, late vitamin K deficiency bleeding is not common and may not be diagnosed by pediatrician. This form of disease can be prevented by vitamin K prophylaxis administration after birth.

Subclinical liver dysfunction in one-month-old infants with a low activity of vitamin K dependent coagulant factors assessed by normotest.

To clarify features of late vitamin K deficiency hemorrhagic disease in Japanese infants, seventeen of 1,687 infants screened by normotests were examined for signs and symptoms suggesting hepatobiliary diseases. Clinical observations disclosed findings suggesting hepatobiliary diseases in 7 of the 17 selected infants with normotest values of less than 40%, and 11 infants had abnormal results in one or more liver function tests. Taken together, 14 of the 17 infants had findings suggesting hepatobiliary diseases. Upon vitamin K supplementation normotest values improved in various degrees in all infants, whether or not they had signs or symptoms of hepatobiliary diseases. Late vitamin K deficiency hemorrhagic disease of infancy may be related to subclinical hepatobiliary diseases.

NO INFLUENCE OF MATERNAL VITAMIN K SUPPLEMENTATION ON VITAMIN K CONCENTRATION IN BREASTMILK

Haemorrhagic disease in breastfed infants caused by vitamin K deficiency can be prevented by oral or parenteral vitamin K administration. Low vitamin K intake with breastmilk may be responsible for the late onset vitamin K deficiency. Therefore we measured vitamin K intake of 28 healthy term breastfed infants at 6, 28 and 90 days of age in a longitudinal randomized study. 16 mothers received a daily oral vitamin K1 supplement (100ug, Milusan®). Milk intake was evaluated by 24 hour testweighing and vitamin K1 concentration in milk was measured employing the HPLC-technique. Vitamin K, intake was similar in the two groups and no influence of age was detected. (Tab., intake in ug/d).However, vitamin K1 intake of all infants was substantially below the RDI value of 10ug/day. (Am.J.Clin.Nutr;1987;45;687-92). Therefore low vitamin K intake with breastmilk might be responsible for late onset vitamin K deficiency in some infants.

Late neonatal vitamin K deficiency associated with subclinical liver dysfunction in human milk-fed infants

because of the small number of epidermal appendages, or to other causes is not known. Scaling of the skin did not seem to be as consistent a feature of any form of ectodermal dysplasia other than X-L HED, although the numbers are too small to be conclusive. Early diagnosis of X-L HED has several advantages. Life-threatening complications can be prevented, genetic counseling can be given early, and the parents have an opportunity to plan appropriately for the future (e.g., changing the environment to control heat exposure, obtaining and maintaining adequate dental and medical insurance). Scaling or peeling of the skin of a newborn infant, especially a male infant, should alert the examiner to the possibility of X-L HED. Careful, directed examination is warranted and a detailed family history should be obtained. Examination of the mother may be helpful. If suspicion is high, dental radiographs will reveal diagnostic tooth abnormalities. Skin biopsy is usually not necessary for confirmation.

Screening for late neonatal vitamin K deficiency by acarboxyprothrombin in dried blood spots.

Acarboxyprothrombin (protein induced by vitamin K absence or antagonist-II (PIVKA-II] concentrations in dried blood spots were determined in 19,029 infants at about 1 month of age as an indicator of vitamin K deficiency. We observed 51 cases with raised blood concentrations of PIVKA-II (greater than 4 AU/ml), nine of whom showed very high concentrations (greater than 20 AU/ml). For infants who did not receive vitamin K prophylaxis at birth, the incidence of the PIVKA-II test yielding positive results was significantly higher in those solely breast fed (0.51%) compared with those fed formula milk (0.18%). Among solely breast fed infants, the incidence of a very high result of the PIVKA-II test was 0.14% in those who had not received vitamin K prophylaxis at birth, 0.04% in those who received 2 mg orally, and 0.03% in those who received 2 mg orally plus a further dose of 2-4 mg orally at 7 days. Thus vitamin K prophylaxis at birth did not completely prevent vitamin K deficiency at 1 month. We administered vitamin K therapeutically to all infants whose PIVKA-II test yielded a positive result at 1 month. Only one infant with a positive result developed late neonatal intracranial haemorrhage.