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Reversible coagulopathy associated with vitamin E excess.
Timothy David Green1, David M Williams2, Jack Sharman3
1Diabetes and Endcrinology, Swansea Bay University Health Board, Port Talbot, UK timdg10@gmail.com.
BMJ Case Reports
|June 11, 2025
Summary
Excessive vitamin E intake can lead to coagulopathy, a blood clotting disorder. This case highlights the need for careful monitoring of vitamin E supplementation, especially in patients with absorption issues, to prevent adverse effects.
Area of Science:
- Biochemistry
- Hematology
- Nutritional Science
Background:
- Vitamin E is a crucial dietary antioxidant.
- Excessive vitamin E can impair blood coagulation, particularly with compromised vitamin K status.
- Bariatric surgery, like biliopancreatic diversion, can lead to micronutrient deficiencies.
Purpose of the Study:
- To report a case of vitamin E-induced coagulopathy in a patient with a history of bariatric surgery.
- To emphasize the importance of monitoring vitamin E levels and patient adherence to supplementation protocols.
Main Methods:
- Case report of an elderly female patient.
- Review of coagulation parameters (INR, APTT) before and after vitamin E over-administration.
- Assessment of response to vitamin E cessation and vitamin K supplementation.
Main Results:
- The patient developed prolonged INR and APTT after accidental over-administration of vitamin E.
- Coagulation abnormalities resolved upon discontinuation of vitamin E and administration of vitamin K.
- No active bleeding complications were observed.
Conclusions:
- Excessive vitamin E supplementation can induce a reversible coagulopathy.
- Careful patient education and regular monitoring are essential for vitamin replacement therapy.
- This case underscores the potential risks of high-dose vitamin E in susceptible individuals.
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