Bleeding due to Vitamin K Deficiency as Presenting Symptom of Cholestasis

비타민 K 결핍에 의한 출혈로 증상 발현한 담즙정체증

  • Bae, Won Tae (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Yeom, Jung Sook (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Park, Eun Sil (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Seo, Ji Hyun (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Lim, Jae Young (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Park, Chan Hoo (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Woo, Hyang Ok (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Youn, Hee Shang (Department of Pediatrics, Gyeongsang National University College of Medicine)
  • 배원태 (경상대학교 의과대학 소아과학교실) ;
  • 염정숙 (경상대학교 의과대학 소아과학교실) ;
  • 박은실 (경상대학교 의과대학 소아과학교실) ;
  • 서지현 (경상대학교 의과대학 소아과학교실) ;
  • 임재영 (경상대학교 의과대학 소아과학교실) ;
  • 박찬후 (경상대학교 의과대학 소아과학교실) ;
  • 우향옥 (경상대학교 의과대학 소아과학교실) ;
  • 윤희상 (경상대학교 의과대학 소아과학교실)
  • Received : 2005.07.19
  • Accepted : 2005.08.25
  • Published : 2005.09.01

Abstract

Clinical findings in neonates and infants with cholestasis characteristically include prolonged jaundice, acholic stool, pruritus and failure to thrive. We report two cases of cholestasis presenting with spontaneous bleeding due to vitamin K deficiency. Laboratory studies on admission revealed moderate liver dysfunction and a bleeding tendency due to vitamin K deficiency. After administration of vitamin K, the bleeding tendency disappeared. Vitamin K deficiency was resulting from a combination of cholestasis-induced fat malabsorption and low vitamin K supplementation due to breast-milk feeding. Cholestasis should be considered in neonate and infant with a bleeding tendency.

비타민 K 결핍은 드물지만, 소량의 출혈이 지속적일 때 의심할 수 있으며, 담즙정체증과 성장 부진이 있을 때 동반될 수 있다. 저자들은 신생아기와 영아기의 비정상적인 출혈을 주소로 내원하여 담즙 정체증에 의한 비타민 K 결핍으로 진단되었던 2예를 경험하였기에 문헌 고찰과 함께 보고한다.

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