PEDIATRICS Vol. 45 No. 5 May 1970, pp. 857-861
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Cystic Fibrosis Presenting with Severe Hemorrhage Due to Vitamin K Malabsorption: A Report of Three Cases

Ordean L. Torstenson M.D.1, G. Bennett Humphrey M.D., Ph.D.1, J. Roger Edson M.D.2, and Warren J. Warwick M.D.3

1 Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota 55455
2 Department of Laboratory Medicine, University of Minnesota, Minneapolis, Minnesota 55455
3 Department of Pediatrics Medicine, University of Minnesota, Minneapolis, Minnesota 55455

Three patients are discussed who presented with hemorrhagic diatheses who were subsequently diagnosed as having cystic fibrosis. Their prolonged prothrombin times and low levels of vitamin K-dependent clotting factors were due to vitamin K deficiency. In two patients we believe that the vitamin K deficiency was principally due to malabsorption caused by cystic fibrosis. In the third patient, malabsorption, diarrhea, antibiotic therapy, and low dietary intake all played a part in the development of vitamin K deficiency. Cystic fibrosis should be included in the differential diagnosis of patients under 1 year of age presenting with a bleeding tendency.




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