A 5-week-old exclusively breastfed infant who did NOT receive any injection at birth is brought with seizures and pallor. CT head shows an intraparenchymal hemorrhage. PT is markedly prolonged with a normal platelet count. What is the most likely diagnosis?

• A Hemophilia A
• B Neonatal immune thrombocytopenia
• C Disseminated intravascular coagulation
• D Late vitamin K deficiency bleeding ✓

Explanation

Late vitamin K deficiency bleeding peaks at 2 to 8 weeks of age, occurs almost exclusively in exclusively breastfed infants (breast milk contains very little vitamin K), and classically presents with intracranial hemorrhage. Prolonged PT with normal platelets fits vitamin K deficiency. Hemophilia would show a normal PT with prolonged aPTT, and DIC would consume platelets.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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