Haemorrhagic disease

Coumarins are also synthesized by a variety of plant species. Medically, the most significant coumarins are dicoumarol and its derivative, warfarin. Dicoumarol was initially discovered as the active substance in mouldy sweet clover hay, which could induce haemorrhagic disease in cattle. Dicoumarol and warfarin are now used clinically as anticoagulants, as discussed in Chapter 9. 

The only major side-effect of these oral anticoagulants is prolonged bleeding, thus the dosage levels are chosen with care. Dicoumarol was first isolated from spoiled sweet clover hay, as the agent which promoted haemorrhage disease in cattle. Both dicoumarol and warfarin have also been utilized (at high doses) as rat poisons. 

Gil, F., Titarenko, E., Terrada, E., Arcalis, E., and Escribano, J.M. (2006). Successful oral prime-immunization with VP60 from rabbit haemorrhagic disease virus produced in transgenic plants using different fusion strategies. Plant Biotechnol. J. 4(10) 135-143. 

Therapeutically, vitamin K is used in prophylaxis and treatment of deficiency of clotting factor due to dietary deficiency of vitamin K, chronic antimicrobial therapy, malabsorption syndrome, obstructive jaundice, liver diseases such as cirrhosis and hepatitis, in neonates to prevent or treat haemorrhagic disease of new born to counteract the overdosing of oral anticoagulants... 

Nagesha, H. S., Wang, L. F., Hyatt, A. D., Morissy, G. J., Lenghaus, G., and Westbury, H. A. (1995). Self-assembly, antigenicity, and immunogenicity of the rabbit haemorrhagic disease virus (Czechoslovakian strain V-351) capsid protein expressed in baculovirus. Arch. Virol. 140, 1095-1108. 

Kernicterus can occur in small and premature babies, even after small doses of vitamin K, probably because of immature liver function. In its 1997 clinical practice guidelines, the Canadian Paediatric Society recommended that, in order to prevent haemorrhagic disease of the newborn, phytomenadione be given as a single intramuscular injection to all newborns within 6 hours of birth, in a dose of 1 mg for infants with a birth weight of more than 1500 g and half this dose for smaller infants. The dose is crucial, since overdosage carries a serious risk of kernicterus, especially in premature infants. There is only a remote possibility that this treatment might increase the risk of childhood cancer. 

Table 3.4. Factors involved in the production of thrombin in plasma coagulation tests (used in the differential diagnosis of haemorrhagic disease or conditions)...

Manin-Bouyer, G., Khanh, N. B., Linh, P D., Hoa, D, Q., Tuan, L, C., Toumeau, J., Barin, C., Guerbois, H., and Binh, T. V, (1983). Epidemic of haemorrhagic disease in Vietnamese infants caused by warfaiin-contaminated talcs. Lancet 1,230-232,... 

Haemorrhagic disease of the newborn. Placental transfer of vitamin K is inefflcient so deficiency can occur, resulting in neonatal haemorrhage. 

K. Wei, Z. Sun, Z. Yan, Y. Tan, H. Wang, X. Zhu, X. Wang, P. Sheng, and R. Zhu, Effects of Taishan Pinus massoniana pollen polysaccharide on immune response of rabbit haemorrhagic disease tissue inactivated vaccine and on production performance of Rex rabbits. Vaccine, 29 (14), 2530-2536, 2011. 

K Phylloquinone Menaquinones Coenzyme in formation of y-carboxyglutamate in enzymes of blood clotting and bone matrix proteins Impaired blood clotting, haemorrhagic disease... 

A small number of newborn infants have very low reserves of vitamin K and are at risk of potentially fatal haemorrhagic disease. It is therefore generally recommended that all neonates should be given a single prophylactic dose of vitamin K. 

PM Loughnan, PN McDougall. The efficacy of oral vitamin KI implications for future prophylaxis to prevent haemorrhagic disease of the newborn. J Paediatr Child Health 29(3) 171-176, 1993. 

PM Loughnan, PN McDougall, H Balvin, LW Doyle, AL Smith. Late onset haemorrhagic disease in premature infants who received intravenous vitamin Ki. J Paediatr Child Health 32(3) 268-269, 1996. 

For ectasy 3,4-methylenedioxy-N-methylamphetamine, the most commonly reported ADRs occurring in >5% of patienfs using fhe agenf were viral haemorrhagic disease, hypertension, tachycardia, arrhythmias, tachypnoea and hyperthermia [11 ] [12 ] [13 ]. Serotonin syndrome has been associated with the concurrent use of ecstasy and a serotonergic agent [12 ] [13 ]. 

Salmon pancreatic disease Rabbit viral haemorrhagic disease Myxomatosis... 

Eggermont, F.., Logghe, N., Van de Cas-seye, W., Casteels, ., Verstraete, M. and Re-naer, M. (1976) Haemorrhagic disease of the newborn in the offspring of rifampicin and isoniazid treated mothers. Acta paediat. belg., 29, 87. 

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