Late-onset vitamin K deficiency bleeding in infancy in Rostov region: a series of clinical cases

Relevance. Late-onset vitamin K deficiency bleeding is considered a successfully preventable condition, however, current data on morbidity in the group of children who received prophylactic administration of menadion are missing, and the effectiveness of the drug is questionable. At the same time, late diagnosis of this disease often leads to disability and death of patients. The purpose of the study – to demonstrate the high prevalence of late vitamin K-dependent coagulopathy in a group of healthy full-term infants who received prophylactic administration of menadione sodium bisulfite. Materials and methods . The retrospective analysis included all children who had an established diagnosis of late-onset vitamin K deficiency bleeding and were treated at the Rostov Regional Children’s Clinical Hospital. All patients underwent an assessment of their medical history and necessary laboratory examinations. The diagnosis was made on the basis of the following criteria: spontaneous bleeding occurring between day 8 and month 6 of life; and characteristic changes in the coagulation parameters, with no evidence of hereditary coagulopathies. Results . The diagnosis of late-onset vitamin K deficiency bleeding was established in 13 children. 11 of them received prophylactic menadione administration in the hospital. Out of the 8 full-term healthy children who received the prophylaxis, 3 developed spontaneous intracranial hemorrhages and one patient died. In all cases, after the administration of menadione, coagulation parameters returned to normal. Conclusion . Prophylactic administration of menadione is probably not effective enough in preventing late-onset Vitamin K deficiency bleeding. Further research into the effectiveness of this medication may allow us to revise the current recommendations and lower the incidence of this condition.