Vitamin K deficiency

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

  • Increased bleeding

Differential Diagnosis

Coagulopathy

Vitamin deficiencies

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

See Also

CDC: Vitamin K Deficiency Bleeding

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