Vitamin K-induced anaphylaxis

Hyo-Hoon Kim; Min-Hye Kim; Shin-Woo Kim; Hyun-Ha Chang; Hye-In Kim; Ju-Young Jeong; Sun Jin; Jung-Wha Park; Hye-Jin Jung; Jong-Myung Lee

doi:10.4168/aard.2014.2.2.146

Journal List > Allergy Asthma Respir Dis > v.2(2) > 1059015

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Kim, Kim, Kim, Chang, Kim, Jeong, Jin, Park, Jung, and Lee: Vitamin K-induced anaphylaxis

Case Report

Allergy, Asthma & Respiratory Disease 2014; 2(2): 146-149.

Published online: 31 May 2014

DOI: https://doi.org/10.4168/aard.2014.2.2.146

Vitamin K-induced anaphylaxis

Hyo-Hoon Kim, Min-Hye Kim, Shin-Woo Kim, Hyun-Ha Chang, Hye-In Kim, Ju-Young Jeong, Sun Jin, Jung-Wha Park, Hye-Jin Jung, Jong-Myung Lee

Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

Correspondence to: Jong-Myung Lee. Department of Internal Medicine, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu 700-721, Korea. Tel: +82-53-420-5546, Fax: +82-53-426-2046, jomlee@knu.ac.kr

Received 17 October 2013 Revised 23 October 2013 Accepted 29 October 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

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.

Keywords: Anaphylaxis, Drug hypersensitivity, Vitamin K, Skin tests

Figures and Tables

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").

Table 1

Results of skin prick test and challenge test for suspected drugs

BP, blood pressure.

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