Late Hemorrhagic Disease of the Newborn: A Fatal Presentation of Hepatobiliary Disease Masquerading as Shaken Baby Syndrome

Abstract

Late hemorrhagic disease of newborns classically presents with intracranial hemorrhage in breast-fed infants who have not received vitamin K prophylaxis. We report a fatal case of vitamin K-deficient coagulopathy in a formula-fed infant who received parenteral vitamin K. This catastrophic presentation, initially mistaken for child abuse because of the associated retinal hemorrhages, revealed a previously unrecognized hepatobiliary disease. Infants presenting with intracranial hemorrhage and coagulopathy with a history of parenteral vitamin K prophylaxis should undergo appropriate investigation to rule out underlying liver pathology.