B 6 and bleeding: A case report of a novel vitamin toxicity

Abstract

Pyridox(am)ine-5-phosphate oxidase deficiency is an inborn error of Vitamin B 6 metabolism that is characterized by neonatal seizures, requiring lifelong therapy with pyridoxal-5-phosphate. We present the first case of a patient with pyridox(am)ine-5-phosphate oxidase deficiency and mild hemophilia A, whose bleeding symptoms were exacerbated by the Vitamin B 6 therapy essential for his epileptic disorder. This report expands the spectrum of known Vitamin B 6 toxicity and demonstrates a need for vigilance in monitoring for bleeding symptoms in patients requiring pyridoxine or pyridoxal-5-phosphate supplementation.