Abstract:
BACKGROUND:Many patients with advanced cancer are malnourished. Anorexia is common, as is the use of chemotherapy, which may cause nausea and poor appetite. Ten per cent of these patients experience haemorrhagic events. AIM:Since vitamin K deficiency (VKD) causes bleeding, to establish the prevalence of VKD in patients with advanced cancer receiving palliative care. METHODS:Serum concentrations of vitamin K(1) and undercarboxylated factor II (PIVKA-II) were determined in 46 (17 male/29 female) inpatients aged 26-85 (mean 58) years. INR and liver function tests (bilirubin, ALT, GGT and ALP) were also performed. RESULTS:Vitamin K(1) was below the lower limit of the reference range (0.33 nmol/l) in 22% of patients. 78% of patients had some degree of functional VKD indicated by raised (>0.2 AU/ml) PIVKA-II. Six patients (13%) had a prolonged INR, all of whom had raised PIVKA-II and GGT; 4 also had vitamin K(1) <0.33 nmol/l. Three patients (6.5%) had clinically significant VKD characterised by INR >1.5, PIVKA-II >10 AU/ml, and undetectable vitamin K(1). CONCLUSIONS:Patients with advanced cancer are prone to VKD which, while usually subclinical, may develop to a clinically relevant prolongation of the INR. Serum measurements of vitamin K(1) and PIVKA-II can be used to detect VKD and monitor vitamin K status before an increased risk of bleeding develops.
journal_name
J Clin Patholjournal_title
Journal of clinical pathologyauthors
Harrington DJ,Western H,Seton-Jones C,Rangarajan S,Beynon T,Shearer MJdoi
10.1136/jcp.2007.052498subject
Has Abstractpub_date
2008-04-01 00:00:00pages
537-40issue
4eissn
0021-9746issn
1472-4146pii
jcp.2007.052498journal_volume
61pub_type
杂志文章abstract::Of 30 children with bleeding disorders exposed to an index tuberculosis case, six developed primary pulmonary tuberculosis and two others became positive skin reactors. There was a significant correlation between the amount of replacement treatment received and the development of evidence of tuberculous infection. Onl...
journal_title:Journal of clinical pathology
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journal_title:Journal of clinical pathology
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journal_title:Journal of clinical pathology
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journal_title:Journal of clinical pathology
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journal_title:Journal of clinical pathology
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