What are the signs of a vitamin K deficiency?

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Signs of Vitamin K Deficiency

Prolonged Prothrombin Time and Bleeding

One of the primary signs of vitamin K deficiency is a prolonged prothrombin time (PT), which indicates a delay in blood clotting. This can lead to excessive bleeding, a hallmark symptom of vitamin K deficiency . Patients may present with various bleeding manifestations, including epistaxis (nosebleeds), gastrointestinal bleeding, and in severe cases, intracranial hemorrhage .

Hemorrhagic Disease in Newborns

Vitamin K deficiency bleeding (VKDB) is particularly critical in newborns. It can be classified into early, classic, and late VKDB based on the timing of presentation. Early VKDB occurs within 24 hours of birth, classic VKDB within the first week, and late VKDB between 2 weeks and 6 months of age. Symptoms include bleeding from the umbilical cord, gastrointestinal tract, and intracranial hemorrhage .

Coagulopathy and Compartment Syndrome

Severe vitamin K deficiency can lead to profound coagulopathy, characterized by deficiencies in clotting factors II, VII, IX, and X. This can result in life-threatening conditions such as compartment syndrome, where bleeding within muscle compartments leads to increased pressure and potential tissue damage. This condition requires immediate medical intervention.

Increased Coagulation Times in Animals

In veterinary contexts, vitamin K deficiency has been observed in cats fed commercial fish-based diets. These animals exhibited increased coagulation times and hepatic or gastrointestinal hemorrhages, which were corrected with vitamin K therapy.

Subclinical Deficiency in Adults

In adults, subclinical vitamin K deficiency can be induced by dietary restrictions. This condition may not immediately affect blood coagulation but can lead to decreased plasma vitamin K1 levels and reduced urinary excretion of gamma-carboxyglutamic acid, a marker of vitamin K status.

Risk Factors and Associated Conditions

Several conditions and factors can increase the risk of vitamin K deficiency. These include poor nutritional status, gastrointestinal diseases, renal failure, and the use of certain antibiotics. Additionally, patients undergoing bariatric surgery, which affects nutrient absorption, are at higher risk for developing vitamin K deficiency .

Conclusion

Vitamin K deficiency manifests primarily through prolonged prothrombin time and bleeding, with severe cases leading to life-threatening conditions such as compartment syndrome and intracranial hemorrhage. Newborns are particularly vulnerable to VKDB, which can be prevented with prophylactic vitamin K administration. Subclinical deficiencies in adults may not immediately affect coagulation but indicate poor vitamin K status. Recognizing and addressing the risk factors and associated conditions is crucial for preventing and managing vitamin K deficiency.