{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:10:11Z","timestamp":1756325411819,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,10,30]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>A woman in her early 60s presented to the emergency room with worsening pain 10 days after an injury to her right abdomen. CT revealed a large subcutaneous haematoma and contained small bowel perforation. She was tachycardic and anaemic and her international normalized ratio (INR) was 2.6 on warfarin for atrial fibrillation. General surgery was consulted and percutaneous drainage of the perforation was recommended, requiring an INR of 1.5 or less. Intravenous (IV) phytonadione was administered to accelerate the lowering of INR; however, the patient developed a severe infusion-related reaction. She recovered once IV phytonadione was stopped and oral diphenhydramine was administered. However, there was still a need for warfarin reversal therapy. A 1.25\u2009mg dose of oral phytonadione was trialled 2.5\u2009hours later and well tolerated. An additional rechallenge of 5\u2009mg by mouth was given without reaction (&lt;8\u2009hours after the initial reaction). Her INR was 1.5 the next morning.<\/jats:p>","DOI":"10.1136\/bcr-2024-261987","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T12:35:12Z","timestamp":1731933312000},"page":"e261987","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Successful oral phytonadione (vitamin K) challenge following an infusion-related reaction to intravenous phytonadione"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4218-7718","authenticated-orcid":false,"given":"T Michael","family":"Farley","sequence":"first","affiliation":[{"name":"Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, Iowa, USA"},{"name":"Pharmacy Practice, South Dakota State University College of Pharmacy and Allied Health Professions, Brookings, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J","family":"Leary","sequence":"additional","affiliation":[{"name":"Hospitalist Program, University of Iowa Health Care, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faith R","family":"Poelker","sequence":"additional","affiliation":[{"name":"University of Iowa College of Pharmacy, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"2025082712393434000_17.11.e261987.1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/1076029616674825","article-title":"Characterizing the Severe Reactions of Parenteral Vitamin K1","volume":"24","author":"Britt","year":"2018","journal-title":"Clin Appl Thromb Hemost"},{"key":"2025082712393434000_17.11.e261987.2","first-page":"417","article-title":"World Health Organization International Agency for Research on Cancer (IARC). Vitamin K substances: IARC monograph","volume":"76","year":"2000","journal-title":"IARC Monogr Eval Carcinog Risks Hum"},{"key":"2025082712393434000_17.11.e261987.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62042-X"},{"key":"2025082712393434000_17.11.e261987.4","unstructured":"Vitamin k1 (phytonadione injectable emulsion) [safety data sheet]. lake forest, IL: Hospira. 2017."},{"key":"2025082712393434000_17.11.e261987.5","unstructured":"Vitamin k1 (AQUAMEPHYTON injectable) [package insert]. 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Drug allergy: an updated practice parameter","volume":"105","author":"Solensky","year":"2010","journal-title":"Ann Allergy Asthma Immunol"},{"key":"2025082712393434000_17.11.e261987.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0090199","article-title":"The severe adverse reaction to vitamin k1 injection is anaphylactoid reaction but not anaphylaxis","volume":"9","author":"Mi","year":"2014","journal-title":"PLoS ONE"},{"key":"2025082712393434000_17.11.e261987.11","doi-asserted-by":"crossref","DOI":"10.3390\/nu12010138","article-title":"Vitamin K as a Diet Supplement with Impact in Human Health: Current Evidence in Age-Related Diseases","volume":"12","author":"Simes","year":"2020","journal-title":"Nutrients"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261987","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:39:46Z","timestamp":1756323586000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261987"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":11,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,18]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/bcr-2024-261987"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261987","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}