DESIGN Case Series
SETTING Tertiary Care Hospitals
SUBJECTS Fifty patient with age ranging from 2 weeks to 12 months admitted and diagnosed to have APCD.
METHODS Medical records of the patients diagnosed to have APCD from August 1990 to August 2000 were reviewed. Demographic and clinical characteristics of the subjects were determined. Data were summarized and analyzed using descriptive statistics.
RESULTS Majority of subjects were male with a male to female ratio of 2.6:1.The mean age of onset of symptoms was 4.5 weeks. Forty-three patients (86%) were purely breastfed. All were born full term with no Vitamin K administration and postnatal complications from mothers with uneventful pregnancies. The most common signs and symptoms were bleeding (80%), pallor (76%), poor suck (70%), seizure (60%), and irritability (56%). Pallor (86%) and bulging fontanelle (56%) were the most common physical examination findings. Intracranial hemorrhage was
noted in 50% of patients. Fifty two percent of patients died.
CONCLUSION APCD Syndrome is usually seen among purely breastfed, well nourished, fullterm infants between 4-12 weeks old delivered at home with no Vitamin K prophylaxis. Bleeding (intracranial), pallor, poor suck, seizures and bulging anterior fontanelles were the most common clinical manifestations. As all infants were not given Vitamin K, its administration may be lifesaving and valuable in preventing neurological complications and mortality.
To describe the clinical features of patients diagnosed with Acquired Prothrombin Complex Deficiency (APCD) Syndrome.
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