Vitamin K deficiency in diarrhoea

Area of Science:

• Pediatrics
• Hematology
• Nutritional Science

Background:

• Vitamin K deficiency is a concern in infants, particularly those with gastrointestinal issues.
• Diarrheal illnesses can impair nutrient absorption, potentially affecting vitamin K status.

Purpose of the Study:

• To determine the prevalence of vitamin K deficiency in infants presenting with diarrheal illness.
• To compare the diagnostic utility of the functional to total prothrombin ratio versus prothrombin time (PT) in identifying vitamin K deficiency in these infants.

Main Methods:

• Infants were classified into acute, protracted, and intractable diarrhea groups, along with healthy controls.
• Coagulation screening tests, including PT and PTTK, were performed.
• Functional and total antigenic levels of prothrombin were measured to calculate the functional to total prothrombin ratio.

Main Results:

• Prothrombin time (PT) was prolonged in 30% of infants with diarrhea versus 11.1% in controls.
• The functional to total prothrombin ratio was significantly lower in infants with diarrhea (0.65 ± 0.41) compared to controls (1.1 ± 0.26) (p < 0.001).
• A low functional to total prothrombin ratio identified vitamin K deficiency in 57.3% of diarrheal infants, approximately double the rate identified by PT alone.

Conclusions:

• The functional to total prothrombin ratio is a more sensitive marker for detecting vitamin K deficiency in infants with diarrhea than PT.
• The malabsorptive state associated with diarrhea is likely a primary factor contributing to vitamin K deficiency in this population.
• Breastfeeding or prior antibiotic use did not show a significant correlation with vitamin K deficiency in the studied infants.