Vitamin K deficiency: Difference between revisions
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===Causes=== | ===Causes=== | ||
*Nutritional deficiency | *Nutritional deficiency | ||
*Malabsorption | *Malabsorption (pancreatic insufficiency, [[celiac sprue]], [[cystic fibrosis]], etc) | ||
*Cholestasis: since it is fat soluble and needs bile salts to be absorbed | *Cholestasis: since it is fat soluble and needs bile salts to be absorbed | ||
*Neonates lack intestinal bacteria that produce vitamin K and therefore require supplementation at birth | |||
**If no vitamin K given, neonate at increased risk of spontaneous hemorrhage | |||
==Clinical Features== | ==Clinical Features== | ||
| Line 26: | Line 28: | ||
*[[Warfarin (Coumadin) Reversal]] | *[[Warfarin (Coumadin) Reversal]] | ||
*[[Coagulopathy (Main)]] | *[[Coagulopathy (Main)]] | ||
==External Links== | |||
[https://www.cdc.gov/ncbddd/vitamink/facts.html CDC: Vitamin K Deficiency Bleeding] | |||
==References== | ==References== | ||
Latest revision as of 18:53, 23 February 2021
Background
- Cofactor for vitamin K-dependent clotting factors II, VII, IX, X
- Used by liver
- Fat soluble
Causes
- Nutritional deficiency
- Malabsorption (pancreatic insufficiency, celiac sprue, cystic fibrosis, etc)
- Cholestasis: since it is fat soluble and needs bile salts to be absorbed
- Neonates lack intestinal bacteria that produce vitamin K and therefore require supplementation at birth
- If no vitamin K given, neonate at increased risk of spontaneous hemorrhage
Clinical Features
Differential Diagnosis
Coagulopathy
Platelet Related
- Too few
- Nonfunctional
Factor Related
- Acquired (Drug Related)
- Warfarin (Coumadin)
- Unfractionated heparin
- Low molecular weight heparin (i.e. enoxaparin (Lovenox), dalteparin)
- Factor Xa Inhibitors (e.g. rivaroxaban, apixaban, fondaparinux, edoxaban)
- Direct thrombin inhibitors (e.g. dabigatran, argatroban, bivalirudin)
- Illness induced
- Genetic
Vitamin deficiencies
- Vitamin A deficiency
- Vitamin B deficiencies
- Vitamin B1 deficiency (Thiamine)
- Vitamin B3 deficiency (Pellagra)
- Vitamin B9 deficiency (Folate)
- Vitamin B7 deficiency (Biotin)
- Vitamin B12 deficiency
- Vitamin C deficiency (Scurvy)
- Vitamin D deficiency (Rickets)
- Vitamin E deficiency
- Vitamin K deficiency
- Zinc deficiency
Management
- Fresh Frozen Plasma: 1ml contains 1U of each clotting factor
- Consider Vitamin K oral or IV (subcutaneous not recommended): will take up to 24 hours to work and up to 2 weeks to wear off
Disposition
See Also
External Links
CDC: Vitamin K Deficiency Bleeding