vitamin-k-semiquinone-radical and Pneumonia

The development of coagulation disorders can be dangerous and fatal in the older people, especially those with multiple medical conditions. Vitamin K-dependent coagulation disorders are easily overlooked when anticoagulant drugs are not used and the patient shows no signs of bleeding.. We report a case of a 71-year-old male suffering from pulmonary infection with severe coagulation disorder without bleeding symptoms. He also had a history of Parkinson's disease, Alzheimer's disease and cardiac insufficiency. Coagulation tests were normal at the time of admission, prothrombin time (PT) is 13.9 (normal, 9.5-13.1) seconds and the activated partial thromboplastin time (APTT) is 30.2 (normal, 25.1-36.5) seconds. But it turned severely abnormal after 20 days (PT: 136.1 s, APTT: 54.8 s). However, no anticoagulants such as warfarin was used and no bleeding symptoms were observed. Subsequent mixing studies with normal plasma showed a decrease in prothrombin times. Vitamin K deficiency was thought to be the cause of coagulation disorders considering long-term antibiotic therapy, especially cephalosporins, inadequate diet and abnormal liver function. After supplementation with 20 mg of vitamin K, coagulation dysfunction was rescued the next day and serious consequences were effectively prevented.. Overall, timely vitamin K supplementation with antimicrobials that affect vitamin K metabolism requires clinician attention, especially in older patients who are multimorbid, frail or nutritionally compromised, and are admitted to hospital because of an infection that needs antimicrobial therapy are at risk of clotting disorders due to abnormal vitamin K metabolism secondary to altered gut flora, which can exacerbate existing nutritional deficiencies.

Topics: Aged; Anticoagulants; Blood Coagulation; Blood Coagulation Disorders; Humans; Male; Pneumonia; Vitamin K; Vitamin K Deficiency

Topics: 4-Hydroxycoumarins; Angiotensin-Converting Enzyme Inhibitors; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Fibric Acids; France; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Indenes; Meta-Analysis as Topic; Pancreatitis; Pharmacoepidemiology; Pharmacovigilance; Pneumonia; Randomized Controlled Trials as Topic; Treatment Outcome; Venous Thrombosis; Vitamin K

We describe the case of a 22 yr old male patient with cystic fibrosis, who, after long-term antibiotic treatment of pulmonary infection, developed a haemorrhagic diathesis with severe bleeding from the mucus membrane of the mouth, and haematuria. Rapid recovery was observed after infusion of vitamin K. During 8 months of follow-up, no evidence of recurrence of the clotting disturbances and anaemia were noted. The combination of impaired absorption of vitamin K due to underlying disease with the antibiotic-induced suppression of vitamin K synthesis by intestinal bacteria could be a possible explanation for this disorder.

Topics: Adult; Cefuroxime; Cephalosporins; Cystic Fibrosis; Follow-Up Studies; Gentamicins; Hemorrhagic Disorders; Humans; Male; Netilmicin; Pneumonia; Time Factors; Vitamin K

Topics: Blood Coagulation Tests; Cefotetan; Factor VII; Hemostasis; Humans; Pneumonia; Vitamin K

Topics: Adult; Anesthesia, Spinal; Antibodies; Autoimmune Diseases; Blood Coagulation Tests; Blood Protein Electrophoresis; Dicumarol; Eosinophilia; Fibrinogen; Heparin; Humans; Jaundice; Male; Pneumonia; Priapism; Pulmonary Embolism; Steroids; Thrombophlebitis; Vitamin K

Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Asphyxia Neonatorum; Central Nervous System Stimulants; Female; Humans; Infant, Newborn; Male; Oxygen Inhalation Therapy; Pneumonia; Prednisolone; Vitamin K

Topics: Antineoplastic Agents; Chemical and Drug Induced Liver Injury; Diagnosis; Diet; Diet Therapy; Female; gamma-Globulins; Hepatitis; Hepatitis A; Hepatitis B virus; Hyperemesis Gravidarum; Liver Function Tests; Lupus Erythematosus, Systemic; Methyltestosterone; Norethindrone; Pneumonia; Prednisone; Pregnancy; Pregnancy Complications, Infectious; Pyelonephritis; Thioguanine; Toxicology; Vitamin K

Topics: Antifibrinolytic Agents; Benzoates; Child; Humans; Infant; Lung Diseases, Interstitial; Pneumonia; Retinoids; Vitamin K