Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Hemorrhagic Diathesis as the Presenting Symptom of Neonatal Cholestasis

  • Received : 2014.07.31
  • Accepted : 2014.08.23
  • Published : 2014.09.30
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Abstract

A 4-week-old infant presented with a coagulation disorder resulting from a vitamin K deficiency. The vitamin K deficiency was caused by neonatal cholestasis due to biliary atresia. Jaundice, hepatomegaly and pale stools are the predominant presenting symptoms of biliary atresia, none of which were recognized in our patient before admission. However, the patient presented with bleeding caused by vitamin K deficiency. She was fully breastfed and had received adequate doses of vitamin K at birth and from the age of 1 week. In case of a hemorrhagic diathesis due to neonatal cholestasis, timely identification of treatable underlying disorders, in particular biliary atresia, is important because an early surgical intervention results in a better prognosis. Meticulous history taking and a thorough physical exam can be decisive for an early diagnosis and subsequent intervention.

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References

  1. Ijland MM, Pereira RR, Cornelissen EA. Incidence of late vitamin K deficiency bleeding in newborns in the Netherlands in 2005: evaluation of the current guideline. Eur J Pediatr 2008;167:165-9. https://doi.org/10.1007/s00431-007-0443-x
  2. Moyer V, Freese DK, Whitington PF, Olson AD, Brewer F, Colletti RB, et al; North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Guideline for the evaluation of cholestatic jaundice in infants: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2004;39:115-28. https://doi.org/10.1097/00005176-200408000-00001
  3. McKiernan PJ. Neonatal cholestasis. Semin Neonatol 2002;7:153-65. https://doi.org/10.1053/siny.2002.0103
  4. Chardot C. Biliary atresia. Orphanet J Rare Dis 2006;1:28. https://doi.org/10.1186/1750-1172-1-28
  5. Miyao M, Abiru H, Ozeki M, Kotani H, Tsuruyama T, Kobayashi N, et al. Subdural hemorrhage: A unique case involving secondary vitamin K deficiency bleeding due to biliary atresia. Forensic Sci Int 2012;221:e25-9. https://doi.org/10.1016/j.forsciint.2012.04.018
  6. van den Anker JN, Sinaasappel M. Bleeding as presenting symptom of cholestasis. J Perinatol 1993;13:322-4.
  7. Petersen C, Davenport M. Aetiology of biliary atresia: what is actually known? Orphanet J Rare Dis 2013;8:128. https://doi.org/10.1186/1750-1172-8-128
  8. Roberts EA. Neonatal hepatitis syndrome. Semin Neonatol 2003;8:357-74. https://doi.org/10.1016/S1084-2756(03)00093-9

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