PROLONGED DIARRHEA WITH NEAR-FATAL HEMORRHAGE DUE TO HYPOPROTHROMBINEMIA
Authors: W B SCHARFMAN, S PROPP
Journal: Annals of Internal Medicine (1956)

Case Reports1 February 1956PROLONGED DIARRHEA WITH NEAR-FATAL HEMORRHAGE DUE TO HYPOPROTHROMBINEMIAWILLIAM B. SCHARFMAN, M.D., SIMON PROPP, M.D., F.A.C.P.WILLIAM B. SCHARFMAN, M.D.Search for more papers by this author, SIMON PROPP, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-44-2-385 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis report is concerned with a severe hemorrhagic disease which followed prolonged diarrhea. The patient presented as a medical emergency which was promptly relieved by appropriate therapy. Subsequent investigation established the diagnosis of sprue which had caused severe hypoprothrombinemia.Several clinical features of this case deserve emphasis. The hypoprothrombinemia was so extreme as to endanger the patient's life. Further, the immediate medical problem was not characteristic of sprue, but was due to a rare complication of the abnormal physiology of this disease. The infrequency of severe purpura associated with diarrhea probably accounted for the delay in diagnosis. The importance of...Bibliography1. Stefanini M: Clinical features and pathogenesis of tropical sprue, Medicine 27: 379, 1948. CrossrefMedlineGoogle Scholar2. HanesMcBryde FMA: Identity of sprue, non-tropical sprue and celiac disease, Arch. Int. Med. 58: 1, 1936. CrossrefGoogle Scholar3. Ingelfinger FJ: The diagnosis of sprue in non-tropical areas, New England J. Med. 228: 180, 1943. CrossrefGoogle Scholar4. KarkSouterHayward RAWJC: A hemorrhagic diathesis in idiopathic steatorrhea: observations on its association with vitamin K deficiency, Quart. J. Med. 9: 247, 1940. Google Scholar5. CollinsHoffman ENAD: Hemoptysis and hematuria in sprue, Cleveland Clin. Quart. 10: 105, 1943. CrossrefGoogle Scholar6. FullertonInnes HWJA: Case of idiopathic steatorrhea with multiple nutritional deficiencies, Lancet 2: 790, 1936. CrossrefGoogle Scholar7. ButtSnellOsterberg HRAMAE: Preoperative and post-operative administration of vitamin K to patients having jaundice, J. A. M. A. 113: 383, 1939. CrossrefGoogle Scholar8. ClarkDixonButt RLCFHR: Deficiency of prothrombin associated with various intestinal disorders, Proc. Staff Meet., Mayo Clin. 14: 407, 1937. Google Scholar9. ColcherDrachmanAdlersberg HSRD: Management of intractable sprue with cortisone and adrenocorticotropin, Ann. Int. Med. 38: 554, 1953. LinkGoogle Scholar10. Wintrobe MM: Clinical hematology, 3d Ed., 1951, Lea and Febiger, Philadelphia. Google Scholar11. CecilLoch RHRF: A textbook of medicine, 8th Ed., 1951, W. B. Saunders Co., Philadelphia. Google Scholar12. AdlersbergSchein DJ: Clinical and pathological studies in sprue, J. A. M. A. 134: 1459, 1947. CrossrefMedlineGoogle Scholar13. Rodriguez-Molina R: Fundamental concepts in the diagnosis of sprue, Ann. Int. Med. 40: 33, 1953. Google Scholar14. Brinkhous KM: Plasma prothrombin and vitamin K, Medicine 19: 329, 1940. CrossrefGoogle Scholar15. Sodeman WA: Pathologic physiology, 1950, W. B. Saunders Co., Philadelphia. Google Scholar16. AlbrightStewart FJD: Hypovitaminosis of all fat-soluble vitamins due to steatorrhea, New England J. Med. 223: 239, 1940. CrossrefGoogle Scholar17. Matoth Y: Plasma prothrombin in infantile diarrhea, Am. J. Dis. Child. 80: 944, 1950. Google Scholar18. Mackie TT: Vitamin K deficiency in the absence of jaundice, New York State J. Med. 40: 987, 1940. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Albany, N. Y.*Received for publication November 29, 1954.From the Department of Medicine and the Subdepartment of Hematology, Albany Medical College, Union University, Albany, N. Y. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Liver and Blood Coagulation: Physiology and PathologyVitamin K in Medical Practice: AdultsClot Retention in the Kidneys as a Probable Cause of Anuria During Treatment of Haematuria with Epsilon-aminocaproic AcidMalabsorption Syndromes of Enteric Origin 1 February 1956Volume 44, Issue 2Page: 385-391KeywordsChronic diarrheaDiarrheaDysenteryGastroenterology and hepatologyHematology and oncologyHemorrhageVitamin K ePublished: 1 December 2008 Issue Published: 1 February 1956 PDF downloadLoading ...