{"id":123,"date":"2019-05-04T23:01:28","date_gmt":"2019-05-04T20:01:28","guid":{"rendered":"https:\/\/blood-pressure-info.com\/blog\/?p=123"},"modified":"2019-05-03T23:08:08","modified_gmt":"2019-05-03T20:08:08","slug":"deficiency-of-k-vitamin-dependent-factors","status":"publish","type":"post","link":"https:\/\/blood-pressure-info.com\/blog\/2019\/05\/04\/deficiency-of-k-vitamin-dependent-factors\/","title":{"rendered":"Deficiency of K-vitamin-dependent Factors"},"content":{"rendered":"

What is K-Vitamin Deficiency Factors?<\/h2>\n

The development of this pathology is due to impaired synthesis in liver cells (hepatocytes), as well as a decrease in plasma concentration of factors VII, X, II and IX.<\/p>\n

Pathogenesis during Defecit K-Vitamin-dependent Factors<\/h2>\n

According to the mechanism of development, the following types of this syndrome are distinguished:<\/p>\n

    \n
  1. due to insufficient formation of vitamin K in the intestine (hemorrhagic disease of the newborn, K-hypovitaminosis with enteropathy and intestinal dysbacteriosis of drug origin);<\/li>\n
  2. forms associated with insufficient absorption of this fat-soluble vitamin due to the lack of bile in the intestine, for example, with obstructive jaundice;<\/li>\n
  3. in case of competitive displacement of vitamin K from the metabolic chain by its functional antagonists, such substances are: coumarins, warfarins, phenylins;<\/li>\n
  4. forms caused by damage to the liver parenchyma (acute dystrophy of the liver, parenchymal hepatitis, cirrhosis and parasitic lesions).<\/li>\n<\/ol>\n

    Forms characterized by vitamin K deficiency, including the effect of “indirect” anticoagulants, differ from the lesions of the liver parenchyma in that they do not violate all stages of the synthesis of factors II, VII, X and IX, but only its final phase.<\/p>\n

    Incomplete antecedents of Factors II, VII, X, and IX are abbreviated as PIVKA (Proteins Induced by Vitamin Absence, i.e., proteins induced by a lack of vitamin K).<\/p>\n

    In order to properly understand the mechanisms of hemorrhagic syndrome development, it is necessary to take into account the importance and dynamics of the development of depression of individual K-vitamin-dependent factors.<\/p>\n

    Of all the factors, the most severe bleeding (hematomal type) is deficiency of factor IX, the less pronounced mixed type is deficiency VII, and the deficit of factors X and II is less dangerous, leading to the development of bleeding of the Sinyachkov type.<\/p>\n

    Depression of factors VII, X, IX, and II arises in K-hypovitaminosis, not simultaneously, but sequentially.<\/p>\n

    It should be noted that this fact is explained by the time of circulation of these factors in the blood.<\/p>\n

    The half-life of factor VII is 2-6 h, and therefore it first decreases with K-hypovitaminosis and treatment with coumarins. Further, there is a decrease in factors IX and X, the half-life of which is about 30-36 and 48 hours respectively. Prothrombin decreases much later (the half-life is about 4 days). The restoration of the level of factors takes place in the same order after the abolition of anticoagulants and the elimination of K-hypovitaminosis: factor VII is quickly normalized, later factors IX and X, and then only prothrombin is deficient for several more days.<\/p>\n

    Diagnosis of Defetsit K-vitamin-dependent Factors<\/h2>\n

    One of the most common methods for diagnosing the deficiency of K-vitamin-dependent coagulation factors and monitoring anticoagulant therapy is the prothrombin test.<\/p>\n

    This test registers a pronounced deficiency of factors of the prothrombin complex. Also, the test controls depression of only 3 of 4 K-vitamin-dependent factors (VII, X and II), whereas the level of factor IX, which participates only in the internal mechanism of coagulation, does not affect it.<\/p>\n

    It should be noted that the most severe hematoma-type bleedings are directly associated with factor IX deficiency.<\/p>\n

    In some patients with K-vitamin deficiency, especially when taking fast-acting anticoagulants, the level of factor IX can decrease early, and in this situation, bleeding sometimes occurs with a still quite high prothrombin index.<\/p>\n

    In this regard, for all types of deficiency of K-vitamin-dependent factors, as well as to control therapy with indirect anticoagulants, not only the prothrombin test is used, but also a test sensitive to factor IX depression (activated partial thromboplastin time, or autocoagulation test).<\/p>\n

    The advantage of this test is that its implementation does not require the use of special reagents.<\/p>\n","protected":false},"excerpt":{"rendered":"

    What is K-Vitamin Deficiency Factors? The development of this pathology is due to impaired synthesis in liver cells (hepatocytes), as well as a decrease in plasma concentration of factors VII, X, II and IX. Pathogenesis<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"_links":{"self":[{"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/posts\/123"}],"collection":[{"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/comments?post=123"}],"version-history":[{"count":1,"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/posts\/123\/revisions"}],"predecessor-version":[{"id":124,"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/posts\/123\/revisions\/124"}],"wp:attachment":[{"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/media?parent=123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/categories?post=123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blood-pressure-info.com\/blog\/wp-json\/wp\/v2\/tags?post=123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}