Intracranial hemorrhages and late hemorrhagic disease associated cholestatic liver disease

Neurol Sci. 2013 Jan;34(1):51-6. doi: 10.1007/s10072-012-0965-5. Epub 2012 Feb 11.

Abstract

Deficiency of vitamin K predisposes to early, classic or late hemorrhagic disease of the newborn (HDN); of which late HDN may be associated with serious and life-threatening intracranial hemorrhage. Late HDN is characterized intracranial bleeding in infants aged 1 week to 6 months due to severe vitamin K deficiency. Late HDN is still an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is not routinely practiced. Children with cholestatic liver disease are at risk for developing secondary vitamin K deficiency because of fat malabsorbtion and inadequate dietary intake. In this study, we described 11 infants with cholestatic liver disease with different etiologies exhibiting intracranial hemorrhage (ICH). Six patients underwent surgical evacuation of ICH, following the administration of vitamin K and/or fresh frozen plasma. The possibility of cholestatic liver disease should be considered in the treatment of ICH due to vitamin K deficiency.

Publication types

  • Case Reports

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology
  • Cholestasis, Intrahepatic / complications*
  • Cholestasis, Intrahepatic / pathology
  • Fatal Outcome
  • Female
  • Giant Cells
  • Hepatitis / complications
  • Hepatitis / pathology
  • Humans
  • Infant
  • Infant, Newborn
  • Intracranial Hemorrhages / etiology
  • Intracranial Hemorrhages / pathology
  • Intracranial Hemorrhages / surgery
  • Magnetic Resonance Imaging
  • Male
  • Neurosurgical Procedures
  • Plasma
  • Tomography, X-Ray Computed
  • Vitamin K / therapeutic use
  • Vitamin K Deficiency Bleeding / etiology*
  • Vitamin K Deficiency Bleeding / physiopathology
  • Vitamins / therapeutic use

Substances

  • Vitamins
  • Vitamin K