Vitamin K deficiency

Symptoms| bruising, petechiae, hematomas, oozing of blood at surgical or puncture sites, stomach pains, cartilage calcification, and severe malformation of developing bone or deposition of insoluble calcium salts in the walls of arteries.
Causes| insufficient dietary vitamin K1 or vitamin K2 or both
Medication| phytonadione

Vitamin K deficiency results from insufficient dietary vitamin K1 or vitamin K2 or both.[1]

## Contents

* 1 Signs and symptoms
* 2 Cause
* 3 Epidemiology
* 4 See also
* 5 References
* 6 External links

## Signs and symptoms

Symptoms include bruising,[2] petechiae,[2][3] and haematoma.

Vitamin K is changed to its active form in the liver by the enzyme Vitamin K epoxide reductase. Activated vitamin K is then used to gamma carboxylate (and thus activate) certain enzymes involved in coagulation: Factors II, VII, IX, X, and protein C and protein S. Inability to activate the clotting cascade via these factors leads to the bleeding symptoms mentioned above.[citation needed]

Notably, when one examines the lab values in Vitamin K deficiency [see below] the prothrombin time is elevated, but the partial thromboplastin time is normal or only mildly prolonged. This may seem counterintuitive given that the deficiency leads to decreased activity in factors of both the intrinsic pathway (F-IX) which is monitored by PTT, as well as the extrinsic pathway (F-VII) which is monitored by PT. However, factor VII has the shortest half-life of all the factors carboxylated by vitamin K; therefore, when deficient, it is the PT that rises first, since the activated Factor VII is the first to "disappear." In later stages of deficiency, the other factors (which have longer half lives) are able to "catch up," and the PTT becomes elevated as well.

## Cause

Vitamin K1-deficiency may occur by disturbed intestinal uptake (such as would occur in a bile duct obstruction), by therapeutic or accidental intake of a vitamin K1-antagonist such as warfarin, or, very rarely, by nutritional vitamin K1 deficiency. As a result, Gla-residues are inadequately formed and the Gla-proteins are insufficiently active.[citation needed]

## Epidemiology

The prevalence of vitamin K deficiency varies by geographic region. For infants in the United States, vitamin K1 deficiency without bleeding may occur in as many as 50% of infants younger than 5 days old, with the classic hemorrhagic disease occurring in 0.25-1.7% of infants.[2] 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.[4]

Postmenopausal and elderly women in Thailand have high risk of Vitamin K2 deficiency, compared with the normal value of young, reproductive females.[5] Current dosage recommendations for Vitamin K may be too low.[6] The deposition of calcium in soft tissues, including arterial walls, is quite common, especially in those who have atherosclerosis, suggesting that Vitamin K deficiency is more common than previously thought.[7]

Because colonic bacteria synthesize a significant portion of the Vitamin K required for human needs, individuals with disruptions to or insufficient amounts of these bacteria can be at risk for Vitamin K deficiency. Newborns, as mentioned above, fit into this category, as their colons are frequently not adequately colonized in the first five to seven days of life. Another at-risk population comprises those individuals on any sort of long-term antibiotic therapy, as this can diminish the population of normal gut flora.[8]

## See also

* Haemorrhagic disease of the newborn

## References

1. ↑ Vitamin K Deficiency: Background, Physiology, Complications and Prognosis. 24 January 2022. http://emedicine.medscape.com/article/126354-overview.
2. ↑ 2.0 2.1 2.2 Vitamin K Deficiency eMedicine. Author: Pankaj Patel, MD. Coauthor(s): Mageda Mikhail, MD, Assistant Professor. Updated: Feb 13, 2014
3. ↑ "Causes". http://www.mayoclinic.org/symptoms/petechiae/basics/causes/sym-20050724.
4. ↑ American Academy of Pediatrics – Committee on Fetus and Newborn (July 2003). "Controversies concerning vitamin K and the newborn". Pediatrics 112 (1): 191–2. doi:10.1542/peds.112.1.191. PMID 12837888. http://pediatrics.aappublications.org/content/112/1/191.
5. ↑ Bunyaratavej N (2007). "[Experience of vitamin K2 in Thailand"] (in Japanese). Clin Calcium 17 (11): 1752–60. PMID 17982197. https://www.iyaku-j.com/iyakuj/system/M2-1/summary_viewer.php?trgid=1464.
6. ↑ "Vitamin K in the treatment and prevention of osteoporosis and arterial calcification". Am J Health Syst Pharm 62 (15): 1574–81. 2005. doi:10.2146/ajhp040357. PMID 16030366.
7. ↑ "The physiology of vitamin K nutriture and vitamin K-dependent protein function in atherosclerosis". J. Thromb. Haemost. 2 (12): 2118–32. 2004. doi:10.1111/j.1538-7836.2004.00968.x. PMID 15613016.
8. ↑ "Dose Response and Minimal Daily Vitamin K Requirement in Man". Journal of Applied Physiology 23 (3): 387–389. September 1967. doi:10.1152/jappl.1967.23.3.387. PMID 6047959.

## External links

Classification|

* ICD-10: E56.1
* ICD-9-CM: 269.0
* MeSH: D014813
* DiseasesDB: 13962

|

External resources|

* eMedicine: med/2385

* v
* t
* e

Malnutrition or nutrition disorders (E40–E68, 260–269)

Malnutrition|

| Protein-energy
malnutrition|

* Kwashiorkor
* Marasmus
* Catabolysis

|

Vitamin deficiency|

| B vitamins|

* B1: Beriberi / Wernicke–Korsakoff syndrome (Wernicke's encephalopathy
* Korsakoff's syndrome)
* B2: Riboflavin deficiency
* B3: Pellagra (Niacin deficiency)
* B6: Pyridoxine deficiency
* B7: Biotin deficiency
* B9: Folate deficiency
* B12: Vitamin B12 deficiency

|

Other
vitamins|

* A: Vitamin A deficiency/Bitot's spots
* C: Scurvy
* D: Vitamin D deficiency/Rickets/Osteomalacia

Mineral
deficiency|

* Sodium
* Potassium
* Magnesium
* Calcium
* Iron
* Zinc
* Manganese
* Copper
* Iodine
* Chromium
* Molybdenum
* Selenium (Keshan disease)

Overnutrition|

* Overweight
* Obesity

* Childhood obesity
* Obesity hypoventilation syndrome
* Abdominal obesity

|

Vitamin poisoning|

* Hypervitaminosis A
* Hypervitaminosis D
* Hypervitaminosis E
* Megavitamin-B6 syndrome

Mineral overload|

* see inborn errors of metal metabolism, toxicity

* v
* t
* e

Certain conditions originating in the perinatal period / fetal disease (P, 760–779)

Maternal factors and
complications of pregnancy,
labour and delivery|

| placenta:|

* Placenta praevia
* Placental insufficiency
* Twin-to-twin transfusion syndrome

|

chorion/amnion:|

* Chorioamnionitis

umbilical cord:|

* Umbilical cord prolapse
* Nuchal cord
* Single umbilical artery

presentation:|

* Breech birth
* Asynclitism
* Shoulder presentation

Length of gestation
and fetal growth|

* Small for gestational age/Large for gestational age
* Preterm birth/Postmature birth
* Intrauterine growth restriction

Birth trauma|

* scalp
* Cephalhematoma
* Chignon
* Caput succedaneum
* Subgaleal hemorrhage
* Brachial plexus lesion
* Erb's palsy
* Klumpke paralysis

By system|

| Respiratory|

* Intrauterine hypoxia
* Infant respiratory distress syndrome
* Transient tachypnea of the newborn
* Meconium aspiration syndrome
* pleural disease
* Pneumothorax
* Pneumomediastinum
* Wilson–Mikity syndrome
* Bronchopulmonary dysplasia

|

Cardiovascular|

* Pneumopericardium
* Persistent fetal circulation

Haemorrhagic and
hematologic disease|

* Vitamin K deficiency bleeding

* HDN
* ABO
* Anti-Kell
* Rh c
* Rh D
* Rh E
* Hydrops fetalis
* Hyperbilirubinemia
* Kernicterus
* Neonatal jaundice

* Velamentous cord insertion
* Intraventricular hemorrhage
* Germinal matrix hemorrhage
* Anemia of prematurity

Digestive|

* Ileus
* Necrotizing enterocolitis
* Meconium peritonitis

Integument and
thermoregulation|

* Erythema toxicum
* Sclerema neonatorum

Nervous system|

* Perinatal asphyxia
* Periventricular leukomalacia

Musculoskeletal|

* Gray baby syndrome
* muscle tone
* Congenital hypertonia
* Congenital hypotonia

Infectious|

* Vertically transmitted infection
* Neonatal infection
* Congenital rubella syndrome
* Neonatal herpes simplex
* Mycoplasma hominis infection
* Ureaplasma urealyticum infection
* Omphalitis
* Neonatal sepsis
* Group B streptococcal infection
* Neonatal conjunctivitis

Other|

* Miscarriage
* Perinatal mortality
* Stillbirth
* Infant mortality
* Neonatal withdrawal

0.00

(0 votes)

Original source: https://en.wikipedia.org/wiki/Vitamin K deficiency. Read more

|

Retrieved from "https://handwiki.org/wiki/index.php?title=Medicine:Vitamin_K_deficiency&oldid=863638"
*[v]: View this template
*[t]: Discuss this template
*[e]: Edit this template