LATE HEMORRHAGIC-DISEASE OF THE NEWBORN AS A CAUSE OF INTRACEREBRAL BLEEDING

We report a case of a 4-week-old female who presented with late hemorr hagic disease of the newborn (HDN). The newborn was previously healthy , and she received 1 mg of intramuscular vitamin K at birth. She was e xclusively breast-fed. At 4 weeks she began bleeding at the umbilicus and 4 days after she suffered an intracranial hemorrhage. Coagulation studies showed a deficiency of vitamin K-dependent coagulation factors , and the normalization of all clotting studies after administration o f vitamin K confirmed the diagnosis of HDN. Our conclusions are that p hysicians must be alert to mild bleeding in newborns and that prophyla xis with 1 mg of intramuscular vitamin K at birth may be insufficient to prevent late HDN.