Abstract
Congenital combined deficiency of the vitamin K-dependent coagulation factors is a rare bleeding disorder caused by either a defect in the gamma-glutamyl carboxylase or the vitamin K epoxide reductase enzyme complex. The diagnosis should be considered when vitamin-K dependent factor activities are decreased and liver dysfunction, vitamin K deficiency, and factitious coumarin ingestion have been excluded. We report a case of VKCFD in a child resulting from compound heterozygosity for two novel splice site mutations of the gamma-glutamyl carboxylase gene. Oral vitamin K supplementation resulted in partial resolution of proteins and complete resolution of bleeding.
Copyright 2009 Wiley-Liss, Inc.
MeSH terms
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Blood Coagulation Factors / genetics
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Carbon-Carbon Ligases / deficiency*
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Carbon-Carbon Ligases / genetics*
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Child
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Coagulation Protein Disorders / congenital*
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Coagulation Protein Disorders / diagnosis
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Coagulation Protein Disorders / drug therapy
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Coagulation Protein Disorders / genetics*
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Diagnosis, Differential
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Humans
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Male
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Mixed Function Oxygenases / genetics
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Munchausen Syndrome / diagnosis
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Mutation*
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Polymorphism, Single Nucleotide
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Vitamin K / administration & dosage*
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Vitamin K Deficiency / congenital*
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Vitamin K Deficiency / diagnosis
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Vitamin K Deficiency / drug therapy
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Vitamin K Epoxide Reductases
Substances
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Blood Coagulation Factors
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Vitamin K
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Mixed Function Oxygenases
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Vitamin K Epoxide Reductases
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Carbon-Carbon Ligases
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glutamyl carboxylase