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维生素K缺乏性出血作为乳糜泻的主要症状(作者译)

[Vitamin K deficiency bleeding as a leading symptom in celiac disease (author's transl)].

作者信息

Mitterstieler G, Zieglauer H

出版信息

Padiatr Padol. 1978;13(2):175-82.

PMID:643295
Abstract

Haemorrhagic diathesis was a leading symptom in diagnosing celiac disease in 4 patients. In all 4 patients, a duodenal biopsy showed total villous atrophy. Although 3 of the children were typically dystrophic, the weight of the 4th child, an 8 month old boy, was within the normal range. In this patient, who suffered from neither diarrhea nor vomiting, heavy cutaneous and mucous membrane bleeding were the only symptoms of the disease. In all 4 cases the haemorrhagic diathesis could be explained by a low prothrombin complex, whereas the rest of the coagulation tests were normal. After the administration of Vitamin K1 there was an immediate rise in the prothrombin complex and bleeding was quickly stopped. Noteworthy is that due to infections, 3 of the 4 patients, received antibiotics just before the onset of the bleeding. In celiac disease, the conversion from a K-hypovitaminosis into a K-avitaminosis by the administration of antibiotics is discussed.

摘要

出血素质是4例乳糜泻患者诊断中的主要症状。所有4例患者的十二指肠活检均显示完全性绒毛萎缩。虽然其中3名儿童典型地患有营养不良,但第4名儿童,一名8个月大的男孩,体重在正常范围内。该患者既无腹泻也无呕吐,严重的皮肤和黏膜出血是该疾病的唯一症状。在所有4例病例中,出血素质可由凝血酶原复合物水平低来解释,而其余凝血试验均正常。给予维生素K1后,凝血酶原复合物立即升高,出血迅速停止。值得注意的是,由于感染,4例患者中有3例在出血发作前刚刚接受了抗生素治疗。本文讨论了在乳糜泻中,抗生素的使用导致从维生素K缺乏症转变为维生素K缺乏病的情况。

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