Abstract
Routine laboratory investigations carried out in 94 cases with acute spinal cord injury indicated moderate to severe deficiency within the extrinsic prothrombin activator system in 82.2 per cent of the patients. The clotting defect could be shown to be related to subnormal levels of vitamin K dependent plasma factors VII and X. There were 25 drop-outs in this study due to drug interference, irregular administration of vitamin K, intercurrent disease, etc. In the remaining group of 36 patients, none of the common etiological factors of acquired hypoprothrombinemia could be incriminated—such as poor intestinal resorption due to lack of bile salts, hepato-biliary disease, broad-spectrum oral antibiotherapy, drug interaction, hyperpyrexia, prolonged parenteral feeding, etc. In nine (25 per cent) of the cases total correction of factors VII and X was achieved after oral administration of vitamin K; in two (5.5 per cent) partial correction was similarly attained; in the remaining group of 25 (69.5 per cent) who proved to be resistant to oral vitamin K all but two normalised their factors after intravenous administration of the vitamin. These observations support the hypothesis that in acute spinal cord injury intestinal uptake of lipo-soluble substances may temporarily be impaired.
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Hachen, H., Rossier, A., Bouvier, C. et al. Deficiency within the extrinsic prothrombin activator system in patients with acute spinal cord injury. Spinal Cord 12, 132–138 (1974). https://doi.org/10.1038/sc.1974.20
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DOI: https://doi.org/10.1038/sc.1974.20