Vitamin K deficiency
| Vitamin K deficiency | |
|---|---|
| Classification and external resources | |
| ICD-10 | E56.1 |
| ICD-9 | 269.0 |
| eMedicine | med/2385 |
| MeSH | D014813 |
Vitamin K deficiency is a form of avitaminosis resulting from insufficient vitamin K.
Contents |
[edit] Causes
Vitamin K-deficiency may occur by disturbed intestinal uptake (such as would occur in a bile duct obstruction), by therapeutic or accidental intake of vitamin K-antagonists or, very rarely, by nutritional vitamin K deficiency. As a result, Gla-residues are inadequately formed and the Gla-proteins are insufficiently active.
[edit] Symptoms
Symptoms include ecchymosis,[1] petechiae,[1] hematomas,[1] oozing of blood at surgical or puncture sites, stomach pains; risk of massive uncontrolled bleeding; cartilage calcification; and severe malformation of developing bone or deposition of insoluble calcium salts in the walls of arteries.
In infants, it can cause some birth defects such as underdeveloped face, nose, bones, and fingers.[1]
| Condition | Prothrombin time | Partial thromboplastin time | Bleeding time | Platelet count |
|---|---|---|---|---|
| Vitamin K deficiency or warfarin | prolonged | normal or mildly prolonged | unaffected | unaffected |
| Disseminated intravascular coagulation | prolonged | prolonged | prolonged | decreased |
| von Willebrand disease | unaffected | prolonged | prolonged | unaffected |
| Hemophilia | unaffected | prolonged | unaffected | unaffected |
| Aspirin | unaffected | unaffected | prolonged | unaffected |
| Thrombocytopenia | unaffected | unaffected | prolonged | decreased |
| Liver failure, early | prolonged | unaffected | unaffected | unaffected |
| Liver failure, end-stage | prolonged | prolonged | prolonged | decreased |
| Uremia | unaffected | unaffected | prolonged | unaffected |
| Congenital afibrinogenemia | prolonged | prolonged | prolonged | unaffected |
| Factor V deficiency | prolonged | prolonged | unaffected | unaffected |
| Factor X deficiency as seen in amyloid purpura | prolonged | prolonged | unaffected | unaffected |
| Glanzmann's thrombasthenia | unaffected | unaffected | prolonged | unaffected |
| Bernard-Soulier syndrome | unaffected | unaffected | prolonged | decreased or unaffected |
[edit] Vitamin supplementation
According to a study published in the October 14, 2008 edition of PLoS Medicine, Vitamin K (5 mg of K1/day) does not protect against age-related decreasing bone density, but may protect against fractures and cancers, in postmenopausal women[2] taking calcium and vitamin D supplements.[3]
Menaquinone (vitamin K2), but not phylloquinone (vitamin K1), intake is associated with reduced risk of CHD mortality, all-cause mortality and severe aortic calcification.[4][5][6]
In a cohort study in Germany (11319 men, mean follow-up time 8.6y), Menaquinone intake was associated with decreased incidence of advanced prostate cancer.[7]
[edit] Prevalence
The prevalence of vitamin K deficiency varies by geographic region.
For infants in the United States, vitamin K deficiency without bleeding may occur in as many as 50% of infants younger than 5 days old.[1] Therefore, the Committee on Nutrition of the American Academy of Pediatrics recommends that 0.5 to 1.0 mg Vitamin K1 be administered to all newborns shortly after birth.[8]
Postmenopausal and elderly women in Thailand have high risk of Vitamin K2 deficiency, compared with the normal value of young, reproductive females.[9] Current dosage recommendations for Vitamin K may be too low.[10]
The deposition of calcium in soft tissues, including arterial walls, is quite common, especially in those suffering from atherosclerosis, suggesting that Vitamin K deficiency is more common than previously thought.[11]
[edit] See also
[edit] References
- ^ a b c d e Vitamin K Deficiency eMedicine. Author: Pankaj Patel, MD. Coauthor(s): Mageda Mikhail, MD, Assistant Professor. Updated: Dec 18, 2008
- ^ Vitamin K Does Not Prevent Bone Density Loss, but May Prevent Fractures and Cancers Newswise, Retrieved on October 13, 2008.
- ^ Angela M. Cheung et al. (2008), Vitamin K Supplementation in Postmenopausal Women with Osteopenia (ECKO Trial): A Randomized Controlled Trial, http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050196
- ^ Geleijnse JM, Vermeer C, Grobbee DE, et al. (2004). "Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study". J. Nutr. 134 (11): 3100–5. PMID 15514282.
- ^ Erkkilä AT, Booth SL (2008). "Vitamin K intake and atherosclerosis". Curr. Opin. Lipidol. 19 (1): 39–42. doi:10.1097/MOL.0b013e3282f1c57f. PMID 18196985.
- ^ Wallin R, Schurgers L, Wajih N (2008). "Effects of the blood coagulation vitamin K as an inhibitor of arterial calcification". Thromb. Res. 122 (3): 411. doi:10.1016/j.thromres.2007.12.005. PMC 2529147. PMID 18234293. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2529147.
- ^ Nimptsch K, Rohrmann S, Linseisen J (April 2008). "Dietary intake of vitamin K and risk of prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg)". Am. J. Clin. Nutr. 87 (4): 985–92. PMID 18400723. http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=18400723.
- ^ American Academy of Pediatrics Committee on Fetus and Newborn (July 2003). "Controversies concerning vitamin K and the newborn. American Academy of Pediatrics Committee on Fetus and Newborn". Pediatrics 112 (1 Pt 1): 191–2. PMID 12837888. http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=12837888.
- ^ Bunyaratavej N (2007). "[Experience of vitamin K2 in Thailand]" (in Japanese). Clin Calcium 17 (11): 1752–60. PMID 17982197.
- ^ Adams J, Pepping J (2005). "Vitamin K in the treatment and prevention of osteoporosis and arterial calcification". Am J Health Syst Pharm 62 (15): 1574–81. doi:10.2146/ajhp040357. PMID 16030366.
- ^ Berkner KL, Runge KW (2004). "The physiology of vitamin K nutriture and vitamin K-dependent protein function in atherosclerosis". J. Thromb. Haemost. 2 (12): 2118–32. doi:10.1111/j.1538-7836.2004.00968.x. PMID 15613016. http://www.blackwell-synergy.com/doi/full/10.1111/j.1538-7836.2004.00968.x.
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