1987 Fiscal Year Final Research Report Summary

A study on the subclinical hepatic dysfunction as a causative factor of infantile vitamin K deficiency hemorrhage

Research Project

Project/Area Number	60480246
Research Category	Grant-in-Aid for General Scientific Research (B)
Allocation Type	Single-year Grants
Research Field	Pediatrics
Research Institution	Tottori University
Principal Investigator	SHIRAKI Kazuo Department of Pediatrics, Tottori University School of Medicine, 医学部, 教授 (60010229)
Co-Investigator(Kenkyū-buntansha)	OHZEKI Takehiko Department of Pediatrics, Tottori University School of Medicine, 医学部, 助教授 (20152126) KASAGI Tsunakiyo College of Medical Technology, Tottori University, 医療技術短期大学部, 教授 (40032338)
Project Period (FY)	1985 – 1987
Keywords	Infantile vitamin K deficiency hemmorrhage / cholestasis / bile acid / PIVKA-II
Research Abstract	Infantile vitamin K deficiency hemmorrhage is a serious disease, mainly seen in breast-fed infants during early infancy, usually without any apparent causes. We suspected the liver function somehow related to the development of this desease, and studied to elucidate its role as a causative factor of this disease. 1. Eight out of nine infants, who showed low normotest at the age of three weeks, developed hepatic dysfunction later. 2. Serum levels of rapid turnover proteins, such as ceruloplasmin, were elevated in the patients, as well as in the infants who showed low normotest. These results suggested that there was no impairment in the production of the proteins, but there existed bile stasis in the infants with vitamin K deficiency. 3. Serum bile acids were determined in eight infants with vitamin K deficiency with gas-chromatography. All the infants showed markedly elevated serum total bile acid and high C/CDC ratio, which strongly suggested the existense of bile stasis. 4. Vitamin K was administered p.o. to 194 normal newborn infants at the age of 5 days, and serum level of vitamin K and serum PIVKA-II were determined. Among them, seven infants showed no elevation of serum vitamin K after 3 hours post vitamin K adminstration, of whom six became positive for PIVKA- II at the age of 3 weeks, suggesting the presence of vitamin K deficiency. The results of the present study clearly indicate that malabsorption of vitamin K due to "physiologic" cholestasis in early infancy plays an important role in the development of idiopathic infantile vitamin K deficiency hemorrhage.