成人に発症したビタミンＫ依存性血液凝固因子欠乏に関する臨床的解析

概要

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The incidence of deficiency of vitamin K-dependent coagulation factors has recently increased in patients receiving broad-spectrum antibiotics. We had three adult cases of deficiency of vitamin K-dependent coagulation factors for the last one year. The vitamin K-deficiency developed from poor dietary intake and concomitant administration of several broad-spectrum antibiotics in cases 1 and 2 and from intractable self-induced vomiting and purging in case 3. The abnormal prothrombin was demonstrated in the plasmas of all three cases by antigen-antibody crossed immunoelectrophoresis using barbital buffer containing calcium ion. In case 3 the discrepancy between the plasma prothrombin coagulant activity and antigen was demonstrated by serial examination after intravenous administration of vitamin K1. The plasma taken 21 hours after intravenous administration of 30 mg of vitamin K1 contained a significant amount of abnormal prothrombin but the thrombotest, plasma prothrombin time and activated partial thromboplastin time were almost within normal limits. The present results indicated that the deficiency of vitamin K-dependent coagulation factors is not rare in patients with poor or no dietary intake and concomitant treatment of antibiotics.
一般社団法人日本血液学会の論文