ACUTE IDIOPATHIC HYPOPROTHROMBINEMIA, RESPONSE TO MASSIVE DOSES OF VITAMIN K

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Abstract
The fulminating onset of so-called acute idiopathic hypoprothrombinemia with widespread, almost fatal, hemorrhagic phenomena in a middle-aged woman, with dramatic recovery following the administration of large doses of Hykinone (menadione bisulfate) is descr. For the first 24 hrs. it was thought the patient would not survive, since hemorrhage into the throat and soft tissues of the neck produced marked respiratory embarrassment, which fortunately was relieved by sedation and placing the patient in an O2 tent. The prothrombin time (Quick) was 4 min., 25 sec. (control 16.5 sec.), when the patient was first seen. Within the first 24 hrs. 500 cc. of whole citrated blood was administered as well as 280.4 mg. of Hykinone intraven. When the prothrombin time reached 43 sec. (control 15 sec.) 48 hrs. later, the patient began to improve and 1 week later the patient was discharged from the hospital as recovered with a prothrombin time of 24 sec. During this period she received 1500 cc. of whole citrated blood and 585.6 mg. Hykinone intraven. The rapid improvement in this case was attributed to Hykinone, although the value of the blood transfusions was not underestimated. No satisfactory explanation for the hypoprothrombinemia was discovered. The patient had been taking a proprietary preparation containing aspirin and phenacetin in small amounts and the influence of salicylates on prothrombin time is discussed. No similar case had been reported in the available current literature at the time this report went to press.

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