PD1064 - VITAMIN K DEFICIENCY: A POTENTIAL CONTRIBUTING FACTOR TO ANEMIA FOLLOWING METABOLIC/BARIATRIC SURGERY

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PD1064

VITAMIN K DEFICIENCY: A POTENTIAL CONTRIBUTING FACTOR TO ANEMIA FOLLOWING METABOLIC/BARIATRIC SURGERY

Z. Pafili1,2,*, A. Pantelis2,3,4, D. Lapatsanis2,3,4 on behalf of LapObesity – Advanced Bariatric Solutions

1Department of Dietetics, Evangelismos General Hospital, 2LapObesity – Advanced Bariatric Solutions, 3Surgical Department of Obesity and Metabolic Disorders, Athens Medical Group, Psychiko Clinic, 41st Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Athens, Greece

 

Rationale: Anemia is a common long-term nutritional complication of Metabolic Bariatric Surgery (MBS) particularly following hypoabsorption-associated procedures. Although rare, overt vitamin K deficiency may exacerbate anemia by impairing coagulation and increasing menstrual blood loss, potentially contributing to reduced hematocrit levels in females.

Methods: A 36-year-old female with a history of refractory anemia, and conversion from SASI bipartition to Roux-en-Y gastric bypass presented 12 months after conversion with persistent fatigue, cognitive impairment, and dizziness. Her BMI was 23.7 kg/m² after 54% total body weight loss. She adhered to postoperative follow-up and supplementation (oral iron and double-dose multivitamin-mineral complex) and reported adequate protein intake. She had received an iron infusion one month earlier (Hct before infusion 31.4%), yet symptoms persisted.

Results: Laboratory tests were largely normal except for persistent low hematocrit, severe vitamin K1 deficiency, and borderline low zinc. She was treated with a high-potency fat-soluble vitamin complex plus zinc and copper (Zn:Cu 10:1). After one month, symptoms resolved and laboratory values normalized.

 

Table 1. Selected blood test values

Parameter

Individual's value

Reference range

Hct (%)

34.3%

37–47

Ferritin (μg/L

18.4

15–150

Fe (μg/dL)

52

37–145

Vitamin K1 (ng/L)

<60

100–1000

Mg (mmol/L)

0.84

0.66–1.07

Cu (μmol/L)

15.3

12.6–24.3

Zn (μmol/L)

10.5

10.6–27.4

 

Conclusion: Although uncommon after MBS, vitamin K deficiency may indirectly contribute to anemia in menstruating women by increasing menstrual blood loss due to impaired coagulation. Assessing vitamin K status in women with refractory anemia after MBS may be clinically valuable, and correcting deficiencies could represent a cost-effective adjunct to anemia management. 

Disclosure of Interest: None declared