胆道閉鎖症に合併したビタミン K 欠乏症

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Ten cases of hemorrhagic disease accompanied with biliary atresia were reviewed. All infants were fed with breast milk. Hemorrhagic disease appeared from six days to sixty-four days after birth. The effect of vitamin K for the treatment of hemorrhagic disease was excellent. In one case, coagulation factors were measured. Vitamin K dependent factors such as factors IX and X were extremely low, to be less than one percent of the normal level. The etiology of bleeding in these infants is considered as vitamin K deficiency. Bleeding site was the navel in three, the intracranial cavity in five, the nose in two. the subcutaneous tissue in one and the alimentary tract in two patients. Three infants bled at two sites. Intracranial hemorrhage appeared later than other sites, but the reason for this is not clear. Nine infants underwent hepatic proto-enterostomy for the treatment of biliary atresia and only two are alive without jaundice. These two infants have the sequelae of intracranial bleeding. The cause of hemorrhagic disease in infants with biliary atresia is explained as that, because human milk contains only small amount of vitamin K,the breast-fed babies are in a states of predeficiency of vitamin K. Because vitamin K is the fat-soluble vitamin, its absorption is seriously impaired by absence of bile in the G.I. tract, and manifestation of vitamin K deficiency appeares. The change of intestinal flora because of absense of bile and liver damage due to biliary atresia may play some part of this problem.
日本小児外科学会の論文
1980-06-20

胆道閉鎖症に合併したビタミン K 欠乏症

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