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To prevent all forms of VKDB, administration of intramuscular vitamin K at birth has been a standard practice in the United States since 1961 when the American Academy of Pediatrics' recommended the injection for all newborns .
The clinical presentation of early and classic VKDB is variable, with bleeding most commonly occurring from the gastrointestinal tract (53%) and umbilicus (23%) .
Given the potential catastrophic consequences of VKDB and the attenuation of the disease with treatment, rapid diagnosis is paramount.
Despite the most common manifestations of VKDB outlined above, our patient's thymic hemorrhage is an exceedingly rare clinical presentation.
Parents of the four infants with VKDB were asked why they declined vitamin K prophylaxis for their neonate.
A case-control study is under way to assess whether any additional risk factors might contribute to the development of late VKDB in children who do not receive vitamin K at birth.
* Early VKDB occurs within 24 hours of birth, is often severe, and is almost exclusively in infants whose mothers used vitamin K--inhibitory drugs, such as antiepileptics and isoniazid, during pregnancy (1,2).
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- VKH disease
- VKH syndrome
- VKH-like disease
- VKH-like syndrome