{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:10:02Z","timestamp":1762524602247,"version":"build-2065373602"},"reference-count":6,"publisher":"SMC Media","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Vitamin K serves as a critical coenzyme in the\u00a0gamma-carboxylation of clotting factors II, VII, IX, and X, underscoring its essential role in the coagulation cascade. Deficiency of this fat-soluble vitamin is frequently observed in individuals with chronic gastrointestinal disorders, particularly those affecting nutrient absorption. If left untreated, long-term vitamin K deficiency can lead to serious complications, including an increased risk of bleeding, intracranial haemorrhage, and impaired bone mineralization. Given the potential severity of these outcomes, prompt recognition and treatment are imperative. Case report:\u00a0An 87-year-old male with a history of Crohn\u2019s disease and bowel resection 30 years ago, in sustained remission, presented with cutaneous purpura and elevated prothrombin time (PT) and activated partial thromboplastin time (aPTT). Laboratory evaluation revealed low serum vitamin K levels and decreased activity of vitamin K-dependent coagulation factors, which were corrected with vitamin K supplementation. Conclusion:\u00a0This case highlights that acquired vitamin K deficiency should be considered a potential cause of coagulopathy, even in patients with quiescent Crohn\u2019s disease and no active gastrointestinal symptoms. Our patient developed clinically significant bleeding decades after bowel resection, emphasizing that long-term nutritional consequences of gastrointestinal surgery may persist silently. Vigilance for vitamin K and other micronutrient deficiencies is essential in this population. Early recognition and supplementation can reverse coagulopathy, prevent haemorrhagic complications, and improve outcomes through regular monitoring and timely intervention.<\/jats:p>","DOI":"10.12890\/2025_005826","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:41:06Z","timestamp":1760362866000},"source":"Crossref","is-referenced-by-count":0,"title":["Old scars, new bleeds: revisiting coagulopathy in quiescent Crohn\u2019s disease"],"prefix":"10.12890","volume":"12","author":[{"given":"Simran","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Bayhealth Medical Center, Dover, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ridda","family":"Khattak","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Bayhealth Medical Center, Dover, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Bayhealth Medical Center, Dover, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumukh","family":"Arun Kumar","sequence":"first","affiliation":[{"name":"Department of Hematology and Medical Oncology, Bayhealth Medical Center, Dover, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajinkya R.","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Hematology and Medical Oncology, Bayhealth Medical Center, Dover, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"10.12890\/2025_005826_ref1","unstructured":"Morabito JM, Eckert J. Vitamin K. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK551578\/"},{"key":"10.12890\/2025_005826_ref2","unstructured":"Stafford DW. The Vitamin K Cycle. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK536983\/"},{"key":"10.12890\/2025_005826_ref3","doi-asserted-by":"crossref","unstructured":"Kuwabara A, Tanaka K, Tsugawa N, Nakase H, Tsuji H, Shide K, et al. High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease. Osteoporos Int 2009;20:935-942. doi: 10.1007\/s00198-008-0764-2","DOI":"10.1007\/s00198-008-0764-2"},{"key":"10.12890\/2025_005826_ref4","unstructured":"D\u2019Ambrosio D, Cl\u00e9ment M, Mont\u00e9 D, Reniere ML, Garnotel R, Pautas E, et al. Vitamin K Deficiency: An Underestimated Cause of Bleeding in Elderly Patients. Clinical Interventions in Aging 2020;15:1235-1241."},{"key":"10.12890\/2025_005826_ref5","doi-asserted-by":"crossref","unstructured":"Glapa A, Waraczewski K, Nowak JK, Paszkowski J, Borejsza-Wysocki M, Krzyzanowska-Jankowska P, et al. Vitamin K Deficiency in Patients After Restorative Proctocolectomy Inflamm Bowel Dis 2019;25:e17-e18. doi: 10.1093\/ibd\/izy184","DOI":"10.1093\/ibd\/izy184"},{"key":"10.12890\/2025_005826_ref6","unstructured":"Costa RD, Womeldorph C. Vitamin K Deficiency: A Rare Cause of Severe Coagulopathy. Am J Case Rep 2023;24:e938734."}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5826\/4889","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5826\/4890","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/5826\/4890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T14:05:12Z","timestamp":1762524312000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/5826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":6,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.12890\/2025_005826","relation":{"has-manifestation":[{"id-type":"other","id":"1-131-5826-g4889","asserted-by":"subject"},{"id-type":"other","id":"1-131-5826-g4890","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-131","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"type":"electronic","value":"2284-2594"}],"subject":[],"published":{"date-parts":[[2025,10,13]]}}}