Allergy Asthma Respir Dis.  2014 May;2(2):146-149. 10.4168/aard.2014.2.2.146.

Vitamin K-induced anaphylaxis

• Kim HH
• Kim MH
• Kim SW
• Chang HH
• Kim HI
• Jeong JY
• Jin S
• Park JW
• Jung HJ
• Lee JM

• KMID: 2261752
• DOI: http://doi.org/10.4168/aard.2014.2.2.146

Abstract

Vitamin K is a naturally-occurring vitamin used to treat certain coagulation disorders. Despite its frequent use, vitamin K causes allergic reactions very rarely. We report a case of anaphylaxis due to vitamin K (phytonadione) that occurred in a 20-year-old man who has undergone hemorrhoid bleeding. The patient developed immediate whole body urticaria, itching sensation, dyspnea and marked hypotension about 2 minutes after the intravenous administration of vitamin K (phytonadione) and tranexamic acid for the purpose of bleeding control. Skin prick test was performed with vitamin K and tranexamic acid. Vitamin K showed positive response in skin prick test, while tranexamic acid showed negative response in skin prick test and challenge test. To our knowledge, it is the first case report of vitamin K-induced anaphylaxis that is proven with skin test. This case suggests that vitamin K can elicit anaphylaxis and skin test may be helpful in the diagnosis of a suspected allergic response to vitamin K.

Keyword

Anaphylaxis; Drug hypersensitivity; Vitamin K; Skin tests

MeSH Terms

Administration, Intravenous
Anaphylaxis*
Diagnosis
Drug Hypersensitivity
Dyspnea
Hemorrhage
Hemorrhoids
Humans
Hypersensitivity
Hypotension
Pruritus
Sensation
Skin
Skin Tests
Tranexamic Acid
Urticaria
Vitamin K
Vitamins*
Young Adult
Tranexamic Acid
Vitamin K
Vitamins

Figure

• 

  Fig. 1 Skin prick test with vitamin K. Positive reactions were observed at skin prick of vitamin K 1:10 ("1:10"), vitamin K undiluted solution ("undiluted solution"). S, saline as a negative control; H, histamine as a positive control.

• 

  Fig. 2 Skin prick test with tranexamic acid. No reaction was seen in tranexamic acid 1:100 ("T 1:100"), tranexamic acid 1:10 ("1:10") and tranexamic acid undiluted solution ("undiluted solution").

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