{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T20:10:04Z","timestamp":1756325404985,"version":"3.44.0"},"reference-count":24,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,5,21]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Vitamin E refers to a group of compounds that are essential to the diet of animals, where its primary function is an antioxidant. Excessive vitamin E supplementation can cause a reversible coagulopathy in the setting of compromised vitamin K absorption or function. We describe the case of a woman in her mid-80s treated for micronutrient deficiencies following a biliopancreatic diversion as a bariatric procedure 14 years previously. Her coagulation tests were normal until she commenced vitamin E and accidentally over-administered the prescribed dose. This resulted in a coagulopathy, characterised by a prolonged international normalised ratio (INR) and activated partial thromboplastin time (APTT). The patient never had any signs of active bleeding. Both coagulation parameters normalised after stopping the vitamin E and with vitamin K supplementation. This case signifies the importance of careful instruction and monitoring of vitamin replacement, in particular vitamin E supplementation, which in excess leads to coagulopathy.<\/jats:p>","DOI":"10.1136\/bcr-2025-265116","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T23:45:13Z","timestamp":1749599113000},"page":"e265116","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Reversible coagulopathy associated with vitamin E excess"],"prefix":"10.1136","volume":"18","author":[{"given":"Timothy David","family":"Green","sequence":"first","affiliation":[{"name":"Diabetes and Endcrinology, Swansea Bay University Health Board, Port Talbot, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M","family":"Williams","sequence":"additional","affiliation":[{"name":"Diabetes and Endcrinology, Swansea Bay University Health Board, Port Talbot, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Sharman","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrine, Swansea Bay University Health Board, Port Talbot, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey W","family":"Stephens","sequence":"additional","affiliation":[{"name":"Diabetes research group, Swansea University Medical School, Swansea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"2025082712455628000_18.6.e265116.1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.102"},{"key":"2025082712455628000_18.6.e265116.2","unstructured":"NHS Digital . 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