A 3-month-old exclusively breastfed infant who did NOT receive any injection at birth presents with sudden seizures and pallor. CT scan shows an intracranial hemorrhage. Coagulation profile shows markedly prolonged PT and INR with normal platelet count. What is the underlying cause?

• A Hemophilia A
• B Immune thrombocytopenic purpura
• C Disseminated intravascular coagulation
• D Late vitamin K deficiency bleeding ✓

Explanation

Late vitamin K deficiency bleeding occurs between 2 weeks and 6 months, classically in exclusively breastfed infants who missed prophylactic vitamin K at birth. Breast milk contains very little vitamin K. It characteristically presents with intracranial hemorrhage and isolated prolongation of PT and INR due to deficiency of factors II, VII, IX, and X. Hemophilia shows a prolonged aPTT with normal PT, and DIC involves thrombocytopenia.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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