A guide to acquired vitamin K coagulophathy diagnosis and treatment: the Russian perspective

Abstract

Physicians often come across with cases of vitamin K antagonists-dependent coagulopathy for reasons such as accidental use of the vitamin K antagonists (VKA), excessive administration of prescribed anticoagulants of indirect action or not reported administration of vitamin K antagonists due to memory impairment and/or other mental disorders, even deliberate use thereof (attempt to murder or suicide). Rodenticide-poisoning (coumarins, warfarins) via food or occupational accidents are difficult to diagnose. This article discusses different types of acquired vitamin K-dependent coagulopathy. Differential diagnosis is primarily based on patient statements before additional causes of vitamin K deficiency are explored. Even when pathological vitamin K deficiency is not determined, appropriate and urgent medical treatment is necessary: administration of fresh frozen plasma or concentrated factors of the prothrombin complex, administration of vitamin K remedies along with symptomatic therapy. With early diagnosis and prescription of appropriate therapy, prognosis is favorable. Reasons for vitamin K antagonists-dependent coagulopathy cases.

Keywords: Acquired coagulopathy; Rodenticides; Vitamin K.

Fig. 1

Vitamin K deficiency

Fig. 2

Warfarin and acenocoumarol mechanism of action

Fig. 3

Chemical structures of anticoagulants of indirect action

Fig. 4

Therapeutic approaches involving Vitamin K administration