PIVKA-II correlates with INR but not protein C or protein S concentrations in cord blood among newborns

Teruya, Miho; Soundar, Esther; Hui, Shiu‐Ki Rocky; Eldin, Karen W.; Adcock, Dorothy M.; Teruya, Jun

doi:10.3233/npm-16915084

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…Another recent study showed that, in subclinical VK deficiency, PIVKA-II did not correlate with functional protein C levels (20). One possible explanation is that protein C has a more sensitive response to changes in the hepatic VK-dependent carboxylase system (21,22).…”

Section: Discussionmentioning

confidence: 97%

“…Cholestatic newborns are at risk for acquired coagulopathy due to reduced VK absorption (20) and limited tissue reserves that are rapidly catabolized, with 60-70% of a single VK dose being excreted in about 3 days (4). Indeed, oral or parenteral VK supplementation is suggested in full enterally-fed preterm newborns with IFALD, although effective VK intestinal absorption in these patients is unknown.…”

Section: Discussionmentioning

confidence: 99%

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Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease

et al. 2020

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Background and Aim: Intestinal failure-associated liver disease (IFALD) affects one-fifth of neonates receiving parenteral nutrition (PN) for more than 2 weeks. We aimed to define the effect of IFALD on hemostasis of preterm infants. Methods: This is an ancillary analysis of a prospective study aimed at defining coagulation in preterm infants. We included neonates exposed to PN (at least 14 days), in full-enteral feeding. We compared thrombin generation in the presence of thrombomodulin, defined as endogenous thrombin potential-ETP, PT, aPTT between infants with IFALD vs. those without (controls), at birth, and after 30 days. IFALD was defined as conjugated bilirubin ≥1 mg/dl. Results: We enrolled 92 preterm infants (32 IFALD; 60 controls). Cholestatic patients had a lower birthweight, longer exposure to PN, and longer hospitalization. Infants with IFALD showed longer median PT (12.8-vs.-12 sec; p = 0.02) and aPTT (39.2-vs.-36.5 sec; p = 0.04) than controls, with no difference in ETP. Conclusions: Despite prolonged PTs and aPTTs infants with IFALD had similar ETP than those without.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease

et al. 2020

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“…Thus, the correlation between Na-DHA dose and serum levels of Vk1 may be a reasonable explanation. How Na-DHA affects the activity/expression of VKOR, VKORC12425 and protein induced by Vitamin k absence/antagonist II (PIVKA II)26 in females and males will be studied carefully in our next work.…”

Section: Discussionmentioning

confidence: 99%

Serum pharmacokinetics and coagulation aberration induced by sodium dehydroacetate in male and female Wistar rats

Zhang

Ying

Líu

et al. 2017

Sci Rep

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Sodium dehydroacetate (Na-DHA) is used as a preservative in food, animal feeds and cosmetics. Severe haemorrhage in organs and prolongation of coagulation factors in Sprague–Dawley rats has been reported upon oral administration of Na-DHA. We investigated alterations in coagulation parameters and serum pharmacokinetics upon Na-DHA administration. Wistar rats were administered Na-DHA (50–200 mg/kg, p.o.). Weight gain, food consumption, prothrombin time (PT), activated partial thromboplastin time (APTT), serum levels of Vitamin k (Vk)1, and serum levels of Na-DHA were measured, and histopathology undertaken. Significant reductions in body weight, food consumption and serum levels of Vk1, as well as prolonged PT and APTT, were observed. Females were significantly different from males in terms of serum Na-DHA concentration. Congestion in hepatic sinusoids, renal tubules and spleen, as well as haemorrhage in lung alveoli, gastric mucosa, intestinal mucosa and cardiac muscle cells, were observed by histopathological analyses. Correlation of serum Na-DHA via PT and APTT, as well as serum Vk1 via PT and APTT, in females was better than that in males. Female rats are more sensitive than males to Na-DHA. Hence, Na-DHA can induce coagulation aberration in Wistar rats, with higher sensitivity seen in females than males.

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“…[23][24][25] Interestingly, there is a significant linear correlation between INR and PIVKA-II, suggesting that PIVKA-II levels can serve as an alternative to PT/INR in assessing the VK deficient status in neonates. 26 In addition, elevated PIVKA-II precedes any subsequent change in PT. Elevated PIVKA-II levels can be detected before any changes in PT become apparent.…”

Section: Introductionmentioning

confidence: 99%

“…PIVKA‐II levels can be measured by detecting antibodies specific to undercarboxylated prothrombin 23–25 . Interestingly, there is a significant linear correlation between INR and PIVKA‐II, suggesting that PIVKA‐II levels can serve as an alternative to PT/INR in assessing the VK deficient status in neonates 26 . In addition, elevated PIVKA‐II precedes any subsequent change in PT.…”

Section: Introductionmentioning

confidence: 99%

Vitamin K insufficiency and the prophylaxis strategy in term healthy infants: A multicentre study

Perrone,

De Bernardo,

Lembo

et al. 2023

Eur J Clin Investigation

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Background/AimLate vitamin K deficiency bleeding (VKDB) during early infancy is a serious problem worldwide. Vitamin K (VK) deficiency commonly occurs in newborns who are exclusively breastfed. Protein Induced by VK Absence (PIVKA‐II) has been identified as an early indicator of subclinical VK deficiency in neonates, surpassing prothrombin time. To assess PIVKA‐II levels at 48 h, 1 and 3 months of age in full‐term newborns who were exclusively breastfed and received varying VKDB prophylaxis regimens.MethodsA prospective observational study was conducted in four hospitals, enrolling 105 newborns. PIVKA‐II levels were measured using a sandwich‐type enzyme‐linked immunosorbent assay.ResultsAt 48 h of age, there was no significant difference in PIVKA‐II concentrations between newborns who received intramuscular administration of 1 mg of phylloquinone (VK1) and those who received oral administration of 2 mg of VK1 at birth. At 1 and 3 months of life, infants who received any supplementation regimen between 2 and 14 weeks exhibited significantly lower PIVKA‐II concentrations compared to infants who received only 1 mg of intramuscular VK1 at birth. The prophylaxis involving a dose of 1 mg of intramuscular VK1 at birth followed by oral administration of 150 μg/day of VK1 from the 2nd to the 14th week of life showed the lowest PIVKA‐II blood concentrations.ConclusionsOral supplementation of VK1 after discharge significantly reduced PIVKA‐II concentrations in exclusively breastfed term infants. These findings suggest the importance of oral VK1 supplementation in exclusively breastfed infants during their first 3 months of life to avoid the risk of VK insufficiency.

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PIVKA-II correlates with INR but not protein C or protein S concentrations in cord blood among newborns

Abstract: PIVKA-II seems to be a sensitive indicator of mild VK deficiency. Further studies are needed to investigate the lack of relationship between PIVKA-II and functional protein C or S levels.

Cited by 6 publications

References 12 publications

Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease

Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease

Serum pharmacokinetics and coagulation aberration induced by sodium dehydroacetate in male and female Wistar rats

Vitamin K insufficiency and the prophylaxis strategy in term healthy infants: A multicentre study

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