Neonatal Cholestasis Presenting With Seizures Associated With Vitamin K Deficiency: A Case Report

Neonatal Cholestasis is one of the rare yet important causes of Vitamin K deficiency bleeding (VKDB) in infants. VKDB may present as Gastro Intestinal (GI) bleeding and in severe cases as Intracranial hemorrhage. We report a case of a 42 days old, previously healthy, male infant presenting with seizures and GI bleeding. Laboratory investigations revealed direct hyperbilirubinemia and markedly elevated PT/INR. These findings were consistent with neonatal cholestasis and Vitamin K deficiency. Cranial and Abdominal Ultrasonography were normal. The seizure was managed with Vit K and Fresh Frozen Plasma following which his coagulation profile and clinical status improved. Although intracranial hemorrhage could not be confirmed radiologically, this case highlights the importance of considering vitamin K deficiency and underlying hepatobiliary pathology in infants presenting with bleeding manifestations and seizures. Early recognition and treatment are essential to prevent life-threatening complications.