Background: Vitamin K is a vital component within both the intrinsic and extrinsic coagulation cascade as certain factors (II, VII, IX, X and protein C and S) utilize vitamin K as a cofactor during post translational modification. Deficiency of vitamin K can result in the inability to properly form blood clots, both in vivo and in vitro, due to reduced vitamin K dependent factor levels and function. Vitamin K deficiency can result from congenital causes, such as VKOR or CYP2C9 mutations, or acquired causes, such as nutritional deficiencies, antibiotic therapy, or supra-therapeutic warfarin dosing. Results: In this case we present a patient with multifactorial vitamin K deficiency (due to nutritional defects and multiple genetic mutations in VKOR and CYP2C9) that was exacerbated by antibiotic and warfarin therapy during her hospital admission. Conclusion: This case displays the importance of genetic testing prior to warfarin dosing and the role antibiotics play in the coagulation cascade.
CITATION STYLE
Strickland, S. W., Burns, E., Palkimas, S., & Bazydlo, L. A. L. (2018). The sample that would not clot. Clinica Chimica Acta, 485, 272–274. https://doi.org/10.1016/j.cca.2018.06.026
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