The sample that would not clot.

Abstract

BACKGROUND:

Vitamin K is a vital component within both the intrinsic and extrinsic coagulation cascade as certain factors (II, VII, IX, X and protein C and S) utilize vitamin K as a cofactor during post translational modification. Deficiency of vitamin K can result in the inability to properly form blood clots, both in vivo and in vitro, due to reduced vitamin K dependent factor levels and function. Vitamin K deficiency can result from congenital causes, such as VKOR or CYP2C9 mutations, or acquired causes, such as nutritional deficiencies, antibiotic therapy, or supra-therapeutic warfarin dosing.

RESULTS:

In this case we present a patient with multifactorial vitamin K deficiency (due to nutritional defects and multiple genetic mutations in VKOR and CYP2C9) that was exacerbated by antibiotic and warfarin therapy during her hospital admission.

CONCLUSION:

This case displays the importance of genetic testing prior to warfarin dosing and the role antibiotics play in the coagulation cascade.

• Authors: Sydney W Strickland, Emily Burns, Surabhi Palkimas, Lindsay A L Bazydlo
• Journal: Clinica chimica acta; international journal of clinical chemistry (Clin Chim Acta) Vol. 485 Pg. 272-274 (Oct 2018) ISSN: 1873-3492 [Electronic] Netherlands
• PMID: 29958892 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2018 Elsevier B.V. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Anticoagulants
• Warfarin

Topics

• Aged
• Anti-Bacterial Agents (therapeutic use)
• Anticoagulants (therapeutic use)
• Automation, Laboratory
• Blood Coagulation (drug effects)
• Female
• Humans
• Thrombosis (drug therapy)
• Vitamin K Deficiency (drug therapy)
• Warfarin (therapeutic use)