Effetto della terapia con vitamina K sui fattori della coagulazione nella malattia celiaca del bambino.

The Authors carried out a study on 37 untreated coeliac children to investigate the behaviour of K-dependent factors after vitamin K administration. The children were randomized into two groups: 22 children receiving a single dose of 10 mg i.m. of Phytonadione (Konakion, Roche) on the initial day of GFD and 15 children who did not receive vitamin K administration. PT, PTT and clotting activity of Factors II, VII, IX, X were determined before the treatment and/or GFD, and after 24 hours, 7 and 15 days. The results demonstrated that vitamin K administration determined a rapid increase in clotting activity of all K-dependent factors after 24 hours. These values remained normal after 7 and 15 days, except for Factor II, which slightly decreased on the 7th day. On the contrary, the children not treated, had levels similar to those of acute stage. After 7 days these values showed a slight increase and reached normal limits on the 15th day. No significant changes were seen in either PT or PTT in the two groups. They were constantly prolonged, reaching normal limits on the 15th day. These results indicate that the vitamin K deficiency, not only seems constant in children with CD, but also seems responsible for the haemocoagulative deficit of the K-dependent factors. After GFD when intestinal absorption is regained, all parameters returned to normal. The Authors concluded that K-dependent factors can be used as short-term indexes of improved intestinal absorption and that the coeliac children with severely compromised nutritional status can be treated with vitamin K (10 mg bolus).