Vitamin K deficiency


Vitamin K deficiency

Description, Causes and Risk Factors:

Abbreviation: VKD.

Vitamin K is one of the fat-soluble vitamins. It helps the body make proteins that are needed for normal blood clotting. Vitamin K is also needed for making important bone proteins.

vitamin K deficiency

Sources of vitamin K: Vitamin K is found in green leafy vegetables and oils, such as olive, cotton seed, and soya bean. Other foods rich in vitamin K are green peas and beans, watercress, asparagus, spinach, broccoli, oats and whole wheat.

Forms: There are 3 forms of vitamin K:

    Vitamin K1 (phylloquinone, the natural version of K1 and phytonadione, the synthetic type of K1).

  • Vitamin K2 (menaquinone).

  • Vitamin K3 (menaphthone or menadione).

Vitamin K is needed for proper use of calcium in bones. Higher vitamin K levels correspond to greater bone density, while low levels of vitamin K have been found in those with osteoporosis. There is increasing evidence that vitamin K improves bone health and reduces risk of bone fractures, particularly in postmenopausal women who are at risk for osteoporosis.

New studies are suggesting that vitamin K may play a crucial role in cardiovascular health. Vitamin K2 is needed for activating the protein matrix Gla protein (MGP), a calcium binding protein, which is an inhibitor of vascular calcification. When enough vitamin K2 is present it can help prevent calcium buildup in blood vessels that assist in vascular disease.

Vitamin K deficiency is rare in adults. However, people with liver disease, pancreatic disease, celiac disease, bulimia, inflammatory bowel disease, people on strict diets, people with malabsorption, or people who have had abdominal surgeries are at a higher risk.

Certain drugs may also increase the risk of deficiency, such as certain antibiotics or anticoagulant medications. People on anticoagulant drugs should be careful about taking extra vitamin K since it can interfere with the important and potentially life-saving anti-blood clotting effects of these medications.

In a very small percentage of babies the low levels of Vitamin K in the blood can result in a bleeding disorder formerly called Hemorrhagic Disease of the Newborn (HDN), but now known as Vitamin K Deficiency Bleeding (VKDB).

There are three categories of VKDB:

    Early VKDB is rare, and occurs during the 1st 48 hours after birth. It's almost exclusively attributed to anticonvulsants (drugs which prevent fits or seizures) taking by mothers during pregnancy.

  1. Classic VKDB is the most common form and occurs in the 1st week of life in 2.5-15 per 1000 newborns. It's associated with inadequate intake of Vitamin K as a result of a delay in feeding or inadequate volume of breast milk.

  2. Late VKDB is very rare and occurs in infants between 2 and 12 weeks of age in 4.4-7.2 per 100,000 babies. Almost half of these babies will suffer permanent brain damage or death. Most of these babies have cholestatic liver disease or cystic fibrosis.

Symptoms:

Signs and symptoms may include:

    Bleeding gums.

  • Nose bleed.

  • Easy bruising.

  • Oozing blood in the wound.

  • Broken blood vessel.

  • Blood in the urine.

  • Heavy menstrual bleeding in woman.

  • Osteopenia.

  • Osteoporosis.

  • Gastrointestinal bleeding.

Diagnosis:

The exam is often unremarkable. In severe cases, the individual may be weak and pale due to loss of blood. Physical findings may reveal small hemorrhagic spots in the skin (petechiae), a localized collection of blood (hematoma), or oozing of blood from a puncture site. Bruising is common.

Bleeding time, prothrombin time and activated partial thromboplastin time are all elevated.The diagnosis will usually be confirmed by administering an injection of vitamin K. If the vitamin K injection increases the prothrombin level and stops the bleeding, the diagnosis of vitamin K deficiency is confirmed.

The most sensitive marker is the antibody test for high level of des-gamma-carboxyprothrombin (DCP) protein in vitamin K absence (PIVKA).

The plasma level of vitamin K can be measured.

Treatment:

The only way to prevent the deficiency of Vitamin K is by having a diet that has the essential quantity of Vitamin K. Elderly people in particular, should keep a watch and have sufficient intake of this vitamin in their diet. In newborns, this deficiency is treated by giving an injection of 5 mg of the prescribed drug. Adults who suffer from Vitamin K deficiency are prescribed oral medicines for a defined period of time, depending on the individual and the severity of the condition.

Refractory cases may require administration of plasma, fresh frozen plasma or prothrombin complex administration. Packed RBCs may be transfused in cases with significant blood loss. Supportive care is important particularly in cases with intracranial hemorrhages.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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