{"id":151,"date":"2014-12-14T14:28:02","date_gmt":"2014-12-14T19:28:02","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=151"},"modified":"2020-07-11T10:41:29","modified_gmt":"2020-07-11T14:41:29","slug":"prolonged-prothrombin-time","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/prolonged-prothrombin-time\/","title":{"rendered":"Prolonged Prothrombin Time"},"content":{"rendered":"<h2><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/bloodvial.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-9219\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/bloodvial.jpg\" alt=\"bloodvial\" width=\"40\" height=\"242\" \/><\/a>What Is Prolonged Prothrombin Time?<\/h2>\n<span class=\"dropcap\">P<\/span>rolonged prothrombin time (PT) is a laboratory blood test result showing that blood clots too slowly which makes the patient subject to abnormal bleeding.<\/p>\n<p><strong>Q<\/strong>: What does the prothrombin time (PT) test measure?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>: The prothrombin test measures\u00a0the clotting ability of blood protein factors I, II (prothrombin), V, VII, and X. If any of these factors are too low, it takes longer than normal for the blood to clot. Prothrombin is a vitamin K dependent factor meaning a deficiency of vitamin K will cause low prothrombin.<\/p>\n<p style=\"text-align: justify\">Blood is drawn into a blood collection tube with a light blue stopper which has a buffering additive. Tubes must be completely filled.<\/p>\n<h2>What Is Prolonged Prothrombin Time In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Relationship between prolonged prothrombin time and celiac disease.<\/strong> Prolonged prothrombin time is an atypical symptom of celiac disease. Prolonged prothrombin time (PT) out of proportion to the PTT (partial thromboplastin time) is significantly related to all the markers of severe malabsorption.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between prolonged prothrombin time and symptoms.\u00a0<\/strong>Study patients with prolonged PT had lower values of hemoglobin, iron, proteins, cholesterol, and serum aspartate transaminase and significantly higher proportion of diarrhea, weight loss, abdominal pain, and low bone mineral density than controls.<a href=\"#footnote_1_151\" id=\"identifier_1_151\" class=\"footnote-link footnote-identifier-link\" title=\"Cavallaro R, Iovino P, Castiglione F, et al. Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease. European Journal of Gastroenterology and Hepatology. Feb 2004;16(2):219-23.\">1<\/a><\/li>\n<\/ul>\n<h2>How Prevalent Is Prolonged Prothrombin Time In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_bullet black\">\n<li style=\"text-align: justify\">Prolonged prothrombin time has 20% prevalence in untreated celiac disease.<a href=\"#footnote_2_151\" id=\"identifier_2_151\" class=\"footnote-link footnote-identifier-link\" title=\"Cavallaro R, Iovino P, Castiglione F, et al. Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease. European Journal of Gastroenterology and Hepatology. Feb 2004;16(2):219-23.\">2<\/a><\/li>\n<li style=\"text-align: justify\">A study of\u00a0109 children with celiac disease \u00a0found an incidence rate of 35.8% having prolonged prothrombin time at diagnosis.<a href=\"#footnote_3_151\" id=\"identifier_3_151\" class=\"footnote-link footnote-identifier-link\" title=\"Kulo\u011flu Z, Kirsa&ccedil;lio\u011flu CT, Kansu A, Ensari A, Girgin N.&nbsp;Celiac Disease: Presentation of 109 Children.&nbsp;Yonsei Med J.&nbsp;2009 October 31; 50(5): 617&ndash;623.\">3<\/a><\/li>\n<\/ul>\n<h2>What Are The Symptoms Of Prolonged Prothrombin Time?<\/h2>\n<ul class=\"cp_bullet red\">\n<li>Prolonged prothrombin time is marked by excessive bleeding.<\/li>\n<\/ul>\n<h2>How Does Prolonged Prothrombin Time Develop in Celiac Disease?<\/h2>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">Prolonged prothrombin time results from vitamin K depletion induced by malabsorption, resulting in failure to supply vitamin K from the diet, and<\/li>\n<li style=\"text-align: justify\">Dysbiosis, resulting from failure of unbalanced or deficient microbe populations to produce adequate vitamin K in the colon in celiac disease.<\/li>\n<\/ul>\n<h2>Does Prolonged Prothrombin Time Respond To Gluten-Free Diet?<\/h2>\n<p style=\"text-align: justify\">Yes. Celiac disease-related prolonged prothrombin time resolves on Gluten Free Diet. Some patients require parenteral (intravenous) vitamin K therapy.<a href=\"#footnote_4_151\" id=\"identifier_4_151\" class=\"footnote-link footnote-identifier-link\" title=\"Cavallaro R, Iovino P, Castiglione F, et al. Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease. European Journal of Gastroenterology and Hepatology. Feb 2004;16(2):219-23.\">4<\/a><\/p>\n<h2 style=\"text-align: justify\">6 Steps To Improve\u00a0Prolonged Prothrombin Time:<\/h2>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>1<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<b>Treatment<\/b>. This condition responds to the complete elimination of gluten, which is the required treatment that improves both prolonged prothrombin time and gut health.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.<\/li>\n<li>A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.<\/li>\n<li>Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1\/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Correct Your Individual Nutritional Needs.<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eat foods that can replenish missing nutrients. Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<li>Take nutritional supplements as needed.\u00a0Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Recovery<\/strong>. You should begin to feel better within a week and notice more energy as inflammation subsides and the \u00a0absorbing cells that make up the surface lining of your small intestine are better able to function.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.<\/li>\n<li>Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.<a href=\"#footnote_5_151\" id=\"identifier_5_151\" class=\"footnote-link footnote-identifier-link\" title=\"Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.&nbsp;Clinical Science. Apr 2001;100(4):379-86.\">5<\/a><\/li>\n<li>The intestinal lining may take up to a year to heal.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>2<\/strong><\/span><\/span><strong><span style=\"color: #800000\">\u00a0Reduce Inflammation. Foods to Eat and Foods Not to Eat:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).<\/p>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Major Inflammatory Food Types That Reduce Healing<\/strong>:<\/p>\n<ul class=\"cp_bullet red\" style=\"text-align: justify\">\n<li><strong>Damaging Foods<\/strong>. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.<a href=\"#footnote_6_151\" id=\"identifier_6_151\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">6<\/a><\/li>\n<li><strong>Allergenic Foods<\/strong>. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.<\/li>\n<li><strong>Shelf Stable Processed Foods.\u00a0<\/strong>Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_6_151\" id=\"identifier_7_151\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">6<\/a><\/li>\n<li><strong>Fats.<\/strong>\u00a0Limit deep fried foods, trans-fats, saturated fats (animal fat\/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.<a href=\"#footnote_6_151\" id=\"identifier_8_151\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">6<\/a>.<\/li>\n<li><strong>Excessive Refined White Flours\u00a0<\/strong>(bran layer removed)<strong>.\u00a0<\/strong>Includes\u00a0products made from them such as cookies, bread, cakes, pies.\u00a0Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream.\u00a0Also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_6_151\" id=\"identifier_9_151\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">6<\/a><\/li>\n<li><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li><strong>Certain Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_6_151\" id=\"identifier_10_151\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">6<\/a><\/li>\n<li><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_6_151\" id=\"identifier_11_151\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">6<\/a>\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Important Anti-Inflammatory Food Types to Promote Health<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li><strong>Fruits<\/strong>.\u00a0Contain ample amounts of vitamins, minerals and phytochemicals which are\u00a0naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.<\/li>\n<li><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes green leafy vegetables such as lettuce and kale, also onion, broccoli, garlic, and others.<\/li>\n<li><strong>High Quality Complex Carbohydrates<\/strong>. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.<\/li>\n<li><strong>Antioxidants<\/strong>. Protect the body from inflammatory oxidant molecules that continually occur and\u00a0help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as\u00a0nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.<\/li>\n<li><strong>Omega-3 Fatty Acids<\/strong>. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.<\/li>\n<li><strong>Probiotics.\u00a0<\/strong>Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.<\/li>\n<li><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li><strong>Protective Herbs and Spices<\/strong>. \u00a0See below #6 below for examples.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">3<\/span>\u00a0Information Sheet You Can Take to Your Doctor or Other Health Professional:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Click here.<\/p>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><span style=\"color: #800000\"><strong><em><span class=\"dropcap\">4<\/span>\u00a0Manage Your Medications\u00a0Safely<\/em>:<\/strong><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">Certain medications deplete vitamin K which in turn causes prolonged prothrombin time. \u00a0Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below.<\/p>\n<p style=\"text-align: justify\"><strong>ANTIBIOTICS\u00a0<\/strong>disrupt intestinal permeability which complicates celiac disease.<\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Gentomycin, Neomycin, Streptomycin, Cephalosporins, Penicillins\u00a0deplete Vitamin K.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTICONVULSANTS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li style=\"text-align: justify\">Phenobarbital and Barbituates; and Dilantin\u00ae, Tegretol\u00ae, Mysoline\u00ae, Depakane\/Depacon\u00ae deplete Vitamin K.<\/li>\n<\/ul>\n<p><strong>CHOLESTEROL DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\">\n<li>Colestid\u00ae and Questran\u00ae deplete Vitamin K.<\/li>\n<\/ul>\n<p><strong>WEIGHT LOSS DRUGS THAT BIND FAT\u00a0<\/strong>also interfere with absorption of some nutrients.<\/p>\n<ul class=\"cp_bullet blue\">\n<li>Zenicol (Orlistat\u00ae) depletes Vitamin K.<\/li>\n<\/ul>\n\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">5<\/span>Nutritional Supplements To Help Correct Deficiencies:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p>The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.<\/p>\n<ul class=\"cp_bullet orange\">\n<li>Multivitamin\/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.<\/li>\n<li>Vitamin K as prescribed following blood test for status.<\/li>\n<\/ul>\n<p><strong>Storage Note<\/strong>:\u00a0<em>Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet &#8211; not in the bathroom or on the kitchen table<\/em>.\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\">\n<li><span style=\"color: #800000\"><em><strong><span class=\"dropcap\">6<\/span>Manage Natural Remedies:\u00a0<\/strong><\/em><\/span><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Hydration<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.<\/li>\n<li>If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.<\/li>\n<li>Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.<\/li>\n<li>What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Carminatives.\u00a0<\/strong>The following \u00a0anti-inflammatory\u00a0plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.<\/p>\n<p><strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\">\n<li>Raspberry.<\/li>\n<li>Carrot is also a cleansing digestive tonic.<\/li>\n<li>Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.<\/li>\n<li>Redbeets also stimulate and improve digestion and are easily digested.<\/li>\n<li>Cabbage also stimulates and improves digestion and is also a liver decongestant.<\/li>\n<li>Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.<\/li>\n<li>Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.<\/li>\n<\/ul>\n<p><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa. \u00a0Drink as tea or use in cooking.<\/li>\n<li>Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.<\/li>\n<li>Parsley also relieves indigestion.<\/li>\n<li>Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.<\/li>\n<li>Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.<\/li>\n<\/ul>\n<p><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Cloves are also antispasmodic.<\/li>\n<li>Nutmeg is also useful for indigestion.<\/li>\n<li>Ginger.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Exercise Helps<\/strong>:<\/p>\n<p>Exercise improves circulation and rids the body of toxins.<\/p>\n<ul class=\"cp_bullet green\">\n<li>Walking is aerobic exercise that reconditions the whole body to improve stamina.\u00a0Read more about<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">\u00a0Exercise and Fitness<\/a>.<\/li>\n<li>Weight training builds muscle.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<li>Stretching improves flexibilty.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<\/ul>\n<p><strong>Note<\/strong>: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. \n\t\t\t<\/div><\/div>\n<h2>What Do Medical Research Studies Tell About Prolonged Prothrombin Time\u00a0In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4><strong>RESEARCH STUDY SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>\u201cPrevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease.\u201d<\/strong> Study evaluating the prevalence and associations of prolonged PT in celiac adults demonstrated that Vitamin K proteins may play a role in determining or worsening calcium homeostasis disorders in Celiac Disease. Patients with prolonged PT had lower values of hemoglobin, iron, proteins, cholesterol, and serum aspartate transaminase and significantly higher proportion of diarrhea, weight loss, abdominal pain, and low bone mineral density than controls.<a href=\"#footnote_4_151\" id=\"identifier_12_151\" class=\"footnote-link footnote-identifier-link\" title=\"Cavallaro R, Iovino P, Castiglione F, et al. Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease. European Journal of Gastroenterology and Hepatology. Feb 2004;16(2):219-23.\">4<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cCeliac Disease: Presentation of 109 Children.\u201d<\/strong> In this study, clinical and laboratory features of 109 patients with Celiac Disease were retrospectively evaluated to determine presentation and manifestations. Of 109 patients with Celiac Disease, 66 (60.6%) were classical type, 41 (37.6%) were atypical type and 2 (1.8%) were silent type. The mean age was 8.81 \u00b1 4.63 years and the most common symptom was diarrhea (53.2%) followed by failure to thrive, short stature, and abdominal pain. Paleness (40.4%), underweight (34.8%), and short stature (31.2%) were the most common findings.<\/p>\n<p style=\"text-align: justify\">Iron deficiency anemia (81.6%), zinc deficiency (64.1%), prolonged prothrombin time (35.8%), and elevated transaminase levels (24.7%) were the most common laboratory findings. Abdominal distention, iron deficiency, prolonged prothrombin time, hypoalbuminemia, and elevated transaminase levels were more significantly frequent in the classical type than atypical type.<a href=\"#footnote_7_151\" id=\"identifier_13_151\" class=\"footnote-link footnote-identifier-link\" title=\"Kulo\u011flu Z, Kirsa&ccedil;lio\u011flu CT, Kansu A, Ensari A, Girgin N.&nbsp;Celiac Disease: Presentation of 109 Children. Yonsei Med J. 2009 October 31; 50(5): 617&ndash;623.\">7<\/a><\/p>\n<h4 style=\"text-align: justify\"><strong>CASE REPORT SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>&#8220;Supplemental vitamin K improves the stability of anticoagulation in a patient with low tissue stores of vitamin K secondary to coeliac disease.&#8221;<\/strong> This case report describes the unstable course a 57-year-old with celiac disease requiring warfarin for a metallic mitral valve, who had poor INR stability (international normalised ratio is a lab study showing prothrombin time or the time it takes blood to clot) resulting in thrombotic and bleeding complications. Her vitamin K body stores were extremely low. Supplementation of vitamin K (100 \u03bcg daily) resulted in improvement in anticoagulation stability. The percentage time spent within target INR range doubled following vitamin K supplementation.<\/p>\n<p style=\"text-align: justify\">Serology revealed an anti-gliadin antibody level of &gt;100 units and an anti-tissue transglutaminase level of &gt;100 units, suggesting poor adherence to a gluten-free diet. Malabsorption was further supported by low levels of vitamin B12 (109 pmol\/litre; normal range 148\u2013443) and folate (1.9 ng\/ml; normal range 3.5\u201316.1). \u201cThis case illustrates a relatively new approach to managing patients with highly unstable INR levels and provides extra understanding of factors influencing INR stability.\u201d<a href=\"#footnote_8_151\" id=\"identifier_14_151\" class=\"footnote-link footnote-identifier-link\" title=\"Janeczko CE, Sweeney K, Connaghan G. Supplemental vitamin K improves the stability of anticoagulation in a patient with low tissue stores of vitamin K secondary to coeliac disease. BMJ Case Rep. 2009;2009. pii: bcr10.2008.1067. doi: 10.1136\/bcr.10.2008.1067.\">8<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cCeliac disease with diffuse cutaneous vitamin K-deficiency bleeding.\u201d<\/strong>\u00a0This case report describes a 4 year old girl with spontaneous, generalized bruising, abdominal distention, and signs of malnutrition. She had been treated previously with an antibiotic for diarrhea. Laboratory analyses showed the presence of iron-deficiency anemia, mild hypoalbuminemia, and considerably prolonged prothrombin time and activated thromboplastin time. Tests revealed that hemostasis improved after the patient received fresh frozen plasma. A coagulation profile showed a decrease in clotting factors II, VII, IX, and X. The patient was given intravenous vitamin K therapy (5 mg\/d) for 3 d. All coagulation tests were normalized, and bruising started to disappear. Positive serology (immunoglobulin A antitissue transglutaminase and immunoglobulin A antiendomysial antibodies) and small bowel mucosal histopathology confirmed the presence of celiac disease.<\/p>\n<p style=\"text-align: justify\">The child recovered completely after she was put on a gluten-free diet. &#8220;Vitamin K-deficiency bleeding is a rare complication that occurs almost exclusively in patients with typical celiac disease manifestations. In addition to antibiotic therapy, treatment with other drugs that influence vitamin K resorption and metabolism may increase the risk of bleeding in patients with celiac disease with hypoprothrombinemia.&#8221;<a href=\"#footnote_9_151\" id=\"identifier_15_151\" class=\"footnote-link footnote-identifier-link\" title=\"Djuric Z, Zivic S, Katic V. Celiac disease with diffuse cutaneous vitamin K-deficiency bleeding. Adv Ther. 2007 Nov-Dec;24(6):1286-9.\">9<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_151\" class=\"footnote\">Cavallaro R, Iovino P, Castiglione F, et al. Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease. European Journal of <em>Gastroenterology and Hepatology<\/em>. Feb 2004;16(2):219-23.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_151\" class=\"footnote\">Cavallaro R, Iovino P, Castiglione F, et al. Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease. European Journal of Gastroenterology and Hepatology. Feb 2004;16(2):219-23.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_151\" class=\"footnote\">Kulo\u011flu Z, Kirsa\u00e7lio\u011flu CT, Kansu A, Ensari A, Girgin N.\u00a0Celiac Disease: Presentation of 109 Children.\u00a0<em>Yonsei Med J.<\/em>\u00a02009 October 31; 50(5): 617\u2013623.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_151\" class=\"footnote\">Cavallaro R, Iovino P, Castiglione F, et al. Prevalence and clinical associations of prolonged prothrombin time in adult untreated coeliac disease.<em> European Journal of Gastroenterology and Hepatology<\/em>. Feb 2004;16(2):219-23.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_151\" class=\"footnote\">Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.\u00a0<em>Clinical Science<\/em>. Apr 2001;100(4):379-86.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_151\" class=\"footnote\">Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.\u00a0<em>Journal of Gastroenterology and Hepatology<\/em>. 2003;18:479-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_151\" class=\"footnote\">Kulo\u011flu Z, Kirsa\u00e7lio\u011flu CT, Kansu A, Ensari A, Girgin N.\u00a0Celiac Disease: Presentation of 109 Children. <em>Yonsei Med<\/em> J. 2009 October 31; 50(5): 617\u2013623.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_151\" class=\"footnote\">Janeczko CE, Sweeney K, Connaghan G. Supplemental vitamin K improves the stability of anticoagulation in a patient with low tissue stores of vitamin K secondary to coeliac disease. <em>BMJ Case Rep<\/em>. 2009;2009. pii: bcr10.2008.1067. doi: 10.1136\/bcr.10.2008.1067.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_151\" class=\"footnote\">Djuric Z, Zivic S, Katic V. Celiac disease with diffuse cutaneous vitamin K-deficiency bleeding. <em>Adv Ther<\/em>. 2007 Nov-Dec;24(6):1286-9.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_15_151\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Prolonged Prothrombin Time? Prolonged prothrombin time (PT) is a laboratory blood test result showing that blood clots too slowly which makes the patient subject to abnormal bleeding. Q: What does the prothrombin time (PT) test measure? A: The prothrombin test measures\u00a0the clotting ability of blood protein factors I, II (prothrombin), V, VII, and &#8230;<\/p>\n","protected":false},"author":29,"featured_media":9219,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[4,99,1682,782,48,104],"tags":[1059,1900,776,1914,392,1056,1886,1903],"class_list":["post-151","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-blood-component","category-malabsorption-disorders","category-atypical-symptom","category-blood","category-vitamin-k","tag-atypical","tag-blood-component","tag-health-conditions","tag-omega-3-fatty-acids","tag-prolonged-prothrombin-time","tag-symptoms-2","tag-blood","tag-vitamin-k"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/151","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=151"}],"version-history":[{"count":20,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/151\/revisions"}],"predecessor-version":[{"id":15413,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/151\/revisions\/15413"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/9219"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=151"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=151"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=151"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}