Acquired Prothrombin Complex Deficiency

Abstract

Acquired Prothrombin Complex Deficiency (APCD) is a condition of where spontaneous bleeding occurs or because of other processes such as venous puncture or an operation due to a decrease in vitamin K dependent coagulation factor activity (factors II, VII, IX dan X). Prevalence of APCD is approximately around 1 per 2 million populations and it does not relate to gender, race, or some certain ethnics. Intracranial bleeding is the most common manifestation of APCD that can be found. Vitamin K deficiency can be caused due to the pathologist condition or can be acquired. Some pathologic conditions that can cause the deficiency of the vitamin K are: liver parenchymal disease, enteropathy or malabsorption syndrome, the reaction of the vitamin E against vitamin K, erythroid multiple myelomadisseminated intravascular coagulopathy, nephrotic syndrome and white blood cells abnormalities. Furthermore, some acquired conditions that cause the deficiency of the vitamin K are: lack of vitamin K intake through food, side effects from various therapies, and overdose on the use of anticoagulants. Evaluation of coagulation factors needs to be done for screening the diagnosis of APCD in the form of isolation of the coagulation pathway and determining deficiency factors or inhibitor factors. Treatment of APCD patients is intended to control bleeding and eliminate inhibitors either with immunosuppressive therapy or treatment of the underlying disease. Intake of vitamin K, fresh frozen plasma (FFP), packed red blood cells (PRBC), and prothrombin complex concentrates (PCC) has been shown to reduce morbidity and prevent complications. Intake of prophylactic vitamin K1 in newborns is recommended to prevent APCD.