Monday, September 16, 2013

Special K


You are a public health physician investigating a trend of bleeding in newborns. Several unrelated newborns in their first week of life have been hospitalized for various problems. One newborn has cutaneous bleeding, two have gastrointestinal bleeding, and one has intracranial bleeding. In all cases, parents refused any interventions for their children after birth. One mother was on anticonvulsants through the pregnancy, and another was taking a cephalosporin.

Challenge: What's going on?

Image is in the public domain, from Wikipedia.

5 comments:

fiendbyname said...

I just learned about this in class! Hemorrhagic disease of the newborn because of vitamin K deficiency. Usually an injection of vit K is given at birth to prevent this from happening before the baby starts producing it.

sid said...

Vitamin K deficiency

webhill said...

Their parents are ignorant laypeople who choose to listen to the All Natural Crunchy Granola Talking Heads rather than take any actual useful medical advice from the plethora of obstetricians and pediatricians out there who could have warned them that if they didn't allow their newborn to get vitamin K, then the baby would be at risk for hemorrhagic disease of the newborn aka vitamin K deficiency bleeding?

Anna said...

Vitamin K Deficient Bleeding.

Anti-seizure medications and cephalosporins taken by the mother are both particular risk factors for VKDB. VKDB is rare due to vitamin K prophylaxis, but these mothers refused any interventions for their newborns.

Breastfed newborns are also at a higher risk for VKDB, as breast milk is not rich in vitamin K. If these mothers refused interventions, they may have a greater distrust in things they don't consider natural for their children, such as baby formula.

This blog is so much fun, even with a complete lack of anything resembling medical training. Thank goodness my cases are as fictional as my MD.

Craig Chen said...

yes! you are all right. it's true, i wrote this case when i read a news report on the increaesd incidence of vit K deficiency.
-
Special K

This is vitamin K deficiency in the newborn which can cause hemorrhagic disease of the newborn.

Source: UpToDate.