COMMENTARY |
Retired Pediatrician, Newcastle Upon Tyne, United Kingdom
Key Words: HDN, hemorrhagic disease of the newborn
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I can still remember the words written in red ink at the bottom of my essay: "You had a promising idea, but its development was disappointing." Many think that we already know all we really need to know about the use of vitamin K, but I fear my old headmaster might have viewed things rather more critically.
The speed with which people realized how vitamin K could be used to almost eliminate the risk of hemorrhagic disease of the newborn (HDN) was impressive. Indeed, the first article to describe clinical use appeared only 4 years after Danish biochemist Henrik Dam1 described his discovery in Nature in 1935. Use spread rapidly in Europe and America once a commercial product became available in the late 1940s, and when a single dose did not suffice to stop not just classic HDN but also intraventricular hemorrhage in the preterm infant, people started administering bigger doses. It did not take long after that for reports to appear that linked the use of the water-soluble analog menadione (the only preparation then commercially available) with an epidemic of severe
Address correspondence to Edmund Hey, DM E-mail: shey@easynet.co.uk