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The sample that would not clot.

Sydney W Strickland1, Emily Burns1, Surabhi Palkimas1

  • 1University of Virginia Department of Pathology, Charlottesville, VA, United States.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|July 1, 2018
PubMed
Summary
This summary is machine-generated.

This case highlights multifactorial vitamin K deficiency, worsened by antibiotics and warfarin. Genetic testing is crucial before warfarin dosing to ensure proper blood clotting and patient safety.

Keywords:
AntibioticsINRPharmacogeneticsVitamin KWarfarin

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Area of Science:

  • Biochemistry
  • Pharmacology
  • Genetics

Background:

  • Vitamin K is essential for blood coagulation factors synthesis.
  • Vitamin K deficiency impairs clot formation, leading to bleeding risks.
  • Causes include genetic mutations (VKOR, CYP2C9) and acquired factors like nutrition, antibiotics, or warfarin.

Observation:

  • A patient presented with complex vitamin K deficiency.
  • The deficiency stemmed from nutritional issues and genetic mutations in VKOR and CYP2C9.
  • Antibiotic and warfarin therapy during hospitalization significantly worsened the condition.

Findings:

  • Multifactorial vitamin K deficiency was diagnosed.
  • The patient's condition was exacerbated by concurrent antibiotic and warfarin treatments.
  • This case underscores the interplay between genetics, medications, and coagulation.

Implications:

  • Highlights the critical need for genetic testing before prescribing warfarin.
  • Demonstrates the significant impact of antibiotics on the coagulation cascade.
  • Emphasizes personalized medicine approaches for managing anticoagulation and vitamin K status.