vitamin-k-semiquinone-radical and Tuberculosis

Approximately 3% of Tuberculosis (TB) patients have a venous thromboembolic events (VTE). The use of Vitamin K antagonists (VKAs), as anticoagulant, in patients receiving anti TB antimicrobials is often complicated by drug interactions, especially with rifampicin. These patients require frequent monitoring of the International Normalized Ratio (INR), and it is reported that warfarin can not achieve a therapeutic INR. In such cases, abruptly stopping the rifampicin once the course of anti TB antimicrobials is not completed is potentially hazardous. The most recent alternative to prevent thrombotic episodes by using oral agents is represented by novel oral anticoagulants (NOAs) an important breakthrough since they do not require strict laboratory monitoring, frequent dosing adjustments, or dietary restrictions; moreover, they and they are linked with far fewer drug-drug interactions.. We have performed a Systematic Review to retrieve information about studies that have assessed the effect of NOAs administered in combination with anti TB antimicrobials in order to investigate if NOAs could be used in TB patients with VTE that do not achieve a therapeutic INR with VKAs.. The MEDLINE and Google Scholar databases were screened from the inception to 5th of February 2017, using two search strategies: the first one was antimicrobials AND novel oral anticoagulants; the second was antibiotics AND novel oral anticoagulants.. 1011 titles were identified on PubMed and Google Scholar published from the inception to February 5, 2017, of these 17 studies were included in the qualitative synthesis Conclusion: No published data were found that properly assessed the effect of NOAs administered in combination with anti TB antimicrobials. Further studies are needed to establish the safety of NOAs in this clinical scenario. In the meanwhile, a viable alternative to VKAs, in order to prevent complications of VTE related to TB, may be represented by Low Molecular Weight Heparin (LMWH), notwithstanding the limitation of the parental route of administration.

Topics: Administration, Oral; Anticoagulants; Antitubercular Agents; Blood Coagulation; Drug Interactions; Heparin, Low-Molecular-Weight; Humans; Treatment Outcome; Tuberculosis; Venous Thromboembolism; Vitamin K

An 8-month-old child under tuberculosis treatment presented with multiple ecchymotic lesions. A severe coagulopathy was evidenced compatible with vitamin K deficiency [II (3%), VII (2%), IX (3%) and X (1%)]. It was reversed with vitamin K and plasma administration. Rifampicin-induced vitamin K deficiency is very rare, reported only once before, possibly related to an inhibition of vitamin K cycle.

Topics: Antibiotics, Antitubercular; Blood Coagulation Disorders; Child; Humans; Infant; Male; Plasma; Rifampin; Treatment Outcome; Tuberculosis; Vitamin K; Vitamin K Deficiency

Delayed haemorrhage due to vitamin K deficiency in early infancy has rarely been the cause of acquired hemostatic disorders. We report here 11 cases of vitamin K deficiency bleeding (VKDB), despite receiving appropriate dosage of injectible vitamin K at birth. Bleeding symptoms ranged from excessive bleed from cuts to intracranial bleed. Tuberculosis, diarrhea with intermittent antibiotic therapy were some of the associated symptoms. Laboratory tests confirmed acquired bleeding diathesis due to vitamin K deficiency, which was corrected after adequate vitamin K supplementation. VKDB is not an uncommon phenomenon and should be considered in the differential diagnosis of a child with bleeding diathesis.

Topics: Diarrhea; Humans; Infant; Retrospective Studies; Tuberculosis; Vitamin K; Vitamin K Deficiency; Vitamin K Deficiency Bleeding

We report a male infant with congenital tuberculosis who developed cerebral hemorrhage associated with vitamin K deficiency during treatment with isoniazid and rifampin. Despite an absence of risk factors for vitamin K deficiency, the severe hemorrhagic disorder occurred at 4 months of age. We speculate that vitamin K deficiency in the present case may have resulted from a synergic effect of antituberculosis agents and immaturity of vitamin K metabolism and/or its absorption.

Topics: Cerebral Hemorrhage; Humans; Infant; Infectious Disease Transmission, Vertical; Isoniazid; Male; Rifampin; Streptomycin; Tuberculosis; Vitamin K; Vitamin K Deficiency

Topics: Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Autopsy; Chemical and Drug Induced Liver Injury; Female; Humans; Isoniazid; Necrosis; Tuberculin Test; Tuberculosis; Vitamin K

Layton, Herbert W. (Northwestern University Medical School, Chicago, Ill.), and Guy P. Youmans. Effect of dietary factors upon the resistance of albino mice to experimental infection with Mycobacterium tuberculosis. J. Bacteriol. 90:958-964. 1965.-Each of the major nutritional components of a synthetic diet was quantitatively altered to determine its effect upon the resistance of albino mice to infection with Mycobacterium tuberculosis. The animals were challenged after the first 2 weeks of feeding, and the percentage that survived acute death was determined statistically. The level of protein which provided the greatest percentage of survival was 30%; increases or decreases from this level were detrimental. The optimal fat level was found to be 5% for either corn oil or coconut oil. Survival decreased when greater amounts of oil were added, and this effect was especially marked for 40% coconut oil. Vitamin A enhanced survival when increased from the normal level of 20,000 units per kg of diet to 160,000 units, but further increases were harmful. An amount of 75 g/kg of a vitamin B complex mixture afforded optimal resistance, but 25-g shifts in either direction lowered this resistance. Vitamin K-free diets resulted in high levels of survival, and addition of the vitamin resulted in proportional decreases in resistance.

Topics: Animals; Dietary Fats; Dietary Proteins; Mice; Tuberculosis; Vitamin A; Vitamin B Complex; Vitamin K

Topics: Antitubercular Agents; Diet; Diet Therapy; Dietary Carbohydrates; Dietary Fats; Dietary Proteins; Drug Therapy; Humans; Nutritional Status; Tuberculosis; Vitamin A; Vitamin K; Vitamins

Topics: Back Pain; Chondroitin; Glucuronates; Humans; Low Back Pain; Osteoarthritis; Osteoporosis; Prednisolone; Spinal Diseases; Spinal Dysraphism; Tuberculosis; Tuberculosis, Spinal; Vitamin K

Topics: Bilirubin; Blood; Blood Proteins; Geriatrics; Liver Function Tests; Prothrombin; Transaminases; Tuberculosis; Tuberculosis, Pulmonary; Vitamin K

Topics: Biochemical Phenomena; Child; Humans; Infant; Thiamine; Tuberculosis; Vitamin A; Vitamin K; Vitamins

Topics: Aspirin; Endocrine Glands; Muscle Relaxants, Central; Tranquilizing Agents; Tuberculosis; Vitamin A; Vitamin K; Vitamins

Topics: Humans; Milk; Tablets; Tuberculosis; Tuberculosis, Pulmonary; Vitamin A; Vitamin K; Vitamins

Topics: Ascorbic Acid; beta Carotene; Carotenoids; Humans; Plasma; Research; Tuberculosis; Tuberculosis, Pulmonary; Vitamin A; Vitamin K; Vitamins

Topics: Mycobacterium bovis; Mycobacterium tuberculosis; Niacin; Nicotinic Acids; Thiosemicarbazones; Tuberculosis; Vitamin K

Topics: Humans; Tuberculosis; Tuberculosis, Pulmonary; Vitamin A; Vitamin K; Vitamins

Topics: Antifibrinolytic Agents; Ethyl Biscoumacetate; Liver Function Tests; Prothrombin Time; Retinoids; Tuberculosis; Tuberculosis, Pulmonary; Vitamin K

Topics: Antifibrinolytic Agents; Hemoptysis; Humans; Naphthoquinones; Tuberculosis; Tuberculosis, Pulmonary; Vitamin K; Vitamin K 1

Topics: Avitaminosis; Humans; Metabolic Diseases; Tuberculosis; Vitamin A; Vitamin K; Vitamins

Topics: Ascorbic Acid; Blood-Brain Barrier; Flavonoids; Humans; Permeability; Tuberculosis; Tuberculosis, Meningeal; Vitamin A; Vitamin K; Vitamins

Topics: Animals; Antifibrinolytic Agents; Mice; Naphthoquinones; Retinoids; Tuberculosis; Vitamin K

Topics: Alkaloids; Animals; Benzylisoquinolines; Guinea Pigs; Streptomycin; Thiosemicarbazones; Tuberculosis; Vitamin K; Vitamin K 3

Topics: Alkaloids; Aminosalicylic Acid; Benzylisoquinolines; Guinea Pigs; Streptomycin; Tuberculosis; Vitamin K; Vitamin K 3

Topics: Tuberculosis; Vitamin A; Vitamin K; Vitamins

Topics: Amino Acids; Physiological Phenomena; Streptomycin; Tuberculosis; Tuberculosis, Meningeal; Vitamin A; Vitamin K; Vitamins

Topics: Cholestanes; Ergocalciferols; Tuberculosis; Tuberculosis, Cutaneous; Vitamin A; Vitamin D; Vitamin K; Vitamins

Topics: Antifibrinolytic Agents; Hemostatics; Heparin Antagonists; Humans; Tuberculosis; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Vitamin K

Topics: Anti-Bacterial Agents; Bacillus; Gram-Positive Bacteria; Humans; Mycobacterium tuberculosis; Tuberculosis; Vitamin K

Topics: Ascorbic Acid; Nutritional Status; Sputum; Tuberculosis; Vitamin A; Vitamin K; Vitamins