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Bleeding and Vitamin K Deficiency

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Management of Bleeding Patients

Abstract

Vitamin K is a cofactor for human glutamic acid carboxylase enzymes in multiple tissues and organs. The dominant vitamin K activity is gamma-carboxylation of selective glutamic acid residues on coagulation factors X, IX, VII, and II. Humans predominantly rely on green vegetable dietary sources of vitamin K rather than synthesis of vitamin K by intestinal bacteria. Vitamin K deficiency bleeding in newborns is uncommon, potentially devastating, and preventable with vitamin K prophylaxis. Other causes of vitamin K deficiency include prolonged anorexia, malabsorption, and rapid depletion without adequate intake during acute medical and surgical events. The significance and mechanisms of antibiotic-associated vitamin K deficiency remain controversial and incompletely investigated. Management options for vitamin K deficiency include oral and parenteral vitamin K and coagulation factor replacement. Ingestion of “superwarfarin” rodenticides produces a severe and prolonged coagulopathy with potential for major bleeding complications.

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Abbreviations

VKDB:

Vitamin K deficiency bleeding

DIC:

Disseminated intravascular coagulation

APTT:

Activated partial thromboplastin time

PT:

Prothrombin time

INR:

International Normalized Ratio

PIVKA-II:

Protein induced in vitamin K absence-prothrombin

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Authors and Affiliations

  1. Division of Laboratory & Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St., St. Louis, MO, 63110, USA

    Charles S. Eby M.D.

Authors
  1. Charles S. Eby M.D.
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Correspondence to Charles S. Eby M.D. .

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Editors and Affiliations

  1. Departments of Pathology & Immunology, Pediatrics, and Medicine, Baylor College of Medicine Division of Transfusion Medicine & Coagulation Texas Children’s Hospital, Houston, Texas, USA

    Jun Teruya

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Eby, C.S. (2016). Bleeding and Vitamin K Deficiency. In: Teruya, J. (eds) Management of Bleeding Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-30726-8_15

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  • DOI: https://doi.org/10.1007/978-3-319-30726-8_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-30724-4

  • Online ISBN: 978-3-319-30726-8

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