High-Dose Phenobarbital-Induced Vitamin K Deficiency and Petechial Haemorrhage in a Young Female

Phenobarbital is used in the management of seizure. Phenobarbital-induced adverse reactions are mostly common in infants and neonates, and related to its use during maternal age. Hepatic side effects are commonly associated with phenobarbitone. Here we present Vitamin K deficiency and petchial haemorrhage following the intake of high-dose Phenobarbital (2.4 g) as a suicidal attempt in a young female. Initially, her coagulopathy was determined by assessing her high Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT), which were normalized by promptly using phytomenadione (Vitamin K1) intravenously within 6 days in Intensive Care Unit (ICU). Following the administration of phytomenadione injection, her symptoms of petechial haemorrhage were diminished on the fourth day in ICU. There was no significant change in her serum bilirubin level, and the initial raised serum aspartate aminotransferase and alanine aminotransferase returned to normal range within 24 h. The patient found 2 sessions of hemodialysis in first two consecutive days in ICU, and discharged to home without any further complication.