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Published on: December 15, 2011
Celiac disease with diffuse cutaneous vitamin K-deficiency bleeding
Zlatko Djuric1, Sasa Zivic, Vuka Katic
1Department of Gastroenterology, Children's Hospital, and Institute of Pathology, University of Nis School of Medicine, Serbia. zldjuric@yahoo.com
Advances in Therapy
|January 1, 2008
Summary
A rare complication of celiac disease (CD) is vitamin K-deficiency bleeding, presenting as bruising and prolonged clotting times. Prompt vitamin K therapy and a gluten-free diet can effectively treat this condition in children.
Area of Science:
- Pediatrics
- Gastroenterology
- Hematology
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- Vitamin K is essential for synthesizing blood clotting factors.
- Malabsorption in CD can lead to vitamin deficiencies, including vitamin K.
Observation:
- A 4-year-old girl presented with spontaneous bruising, abdominal distention, and malnutrition.
- Laboratory tests revealed iron-deficiency anemia, prolonged prothrombin time (PT) and activated thromboplastin time (aPTT).
- Hemostasis improved with fresh frozen plasma, and coagulation profile showed decreased levels of vitamin K-dependent clotting factors (II, VII, IX, X).
Findings:
- Intravenous vitamin K therapy normalized coagulation tests and resolved bruising.
- Serological and histopathological findings confirmed celiac disease.
- The patient fully recovered after initiating a gluten-free diet.
Implications:
- Vitamin K-deficiency bleeding is a rare but serious complication of celiac disease.
- Early diagnosis and management of CD are crucial to prevent bleeding complications.
- Antibiotic use and other medications can exacerbate vitamin K malabsorption in CD patients.
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