Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1994 June; 87(6): 320–322.
PMCID: PMC1294558

The extent of vitamin K deficiency in patients with cholestatic jaundice: a preliminary communication.


Eleven patients with cholestatic jaundice had measurements of plasma vitamin K1 performed. Seven of these 11 (64%) had subnormal levels. The prothrombin time (PT) was prolonged in three of 15 patients with cholestasis (20%), the patient with the longest PT had the lowest vitamin K1 level. A single intramuscular (im) dose of 10 mg vitamin K1 lowered the PT in 9/15 patients (includes correcting the three prolonged PTs). The initial mean plasma vitamin K1 level rose 24 h later, to a mean plasma level which was 33 times the upper limit of the normal physiological range. These preliminary results suggest that a majority of patients presenting with cholestatic jaundice have low tissue reserves of vitamin K1, and that guidelines for vitamin K1 therapy in patients with cholestatic jaundice should be revised.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (628K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Barkhan P, Shearer MJ. Metabolism of vitamin K1 (phylloquinone) in man. Proc R Soc Med. 1977 Feb;70(2):93–96. [PMC free article] [PubMed]
  • Frick PG, Riedler G, Brögli H. Dose response and minimal daily requirement for vitamin K in man. J Appl Physiol. 1967 Sep;23(3):387–389. [PubMed]
  • Shearer MJ, Mallinson CN, Webster GR, Barkhan P. Clearance from plasma and excretion in urine, faeces and bile of an intravenous dose of tritiated vitamin K 1 in man. Br J Haematol. 1972 May;22(5):579–588. [PubMed]
  • Ansell JE, Kumar R, Deykin D. The spectrum of vitamin K deficiency. JAMA. 1977 Jul 4;238(1):40–42. [PubMed]
  • Pineo GF, Gallus AS, Hirsh J. Unexpected vitamin K deficiency in hospitalized patients. Can Med Assoc J. 1973 Nov 3;109(9):880–883. [PMC free article] [PubMed]
  • Ham JM. Hypoprothrombinaemia in patients undergoing prolonged intensive care. Med J Aust. 1971 Oct 2;2(14):716–718. [PubMed]
  • Klippel AP, Pitsinger B. Hypoprothrombinemia secondary to antibiotic therapy and manifested by massive gastrointestinal hemorrhage. Report of three codes. Arch Surg. 1968 Feb;96(2):266–268. [PubMed]
  • Lipsky JJ. Antibiotic-associated hypoprothrombinaemia. J Antimicrob Chemother. 1988 Mar;21(3):281–300. [PubMed]
  • Hands LJ, Royle GT, Kettlewell MG. Vitamin K requirements in patients receiving total parenteral nutrition. Br J Surg. 1985 Aug;72(8):665–667. [PubMed]
  • Krasinski SD, Russell RM, Furie BC, Kruger SF, Jacques PF, Furie B. The prevalence of vitamin K deficiency in chronic gastrointestinal disorders. Am J Clin Nutr. 1985 Mar;41(3):639–643. [PubMed]
  • Shearer MJ. Vitamin K metabolism and nutriture. Blood Rev. 1992 Jun;6(2):92–104. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press