Des-gamma-carboxyprothrombin (PIVKA II) and plasma vitamin K1 in newborns and their mothers
von Kries, R.; Shearer, M.J.; Widdershoven, J.; Motohara, K.; Umbach, G.; Göbel, U.
Thrombosis and Haemostasis 68(4): 383-387
1992
ISSN/ISBN: 0340-6245 PMID: 1448768 Document Number: 393088
Assessments of the vitamin K status in newborns and their mothers by means of des-gamma-carboxy-prothrombin (PIVKA II) measurement have given equivocal results. Part of the variability could be attributed to differences in sensitivity (i.e. the ability to detect small concentrations) and validity (i.e. ability to detect vitamin K deficiency) of the methods applied. None of these methods have yet been validated with respect to plasma vitamin K-1. In 22 healthy mother/infant pairs PIVKA II was determined using three different assays including ratio Xa/ecarin (Xa/ec), crossed immunoelectrophoresis (CIE), and an ELISA with a monoclonal antibody (MAB). The results were compared with conventional clotting tests and plasma vitamin K-1. The following results were obtained. Cord blood: Clotting tests within age-related normal ranges; PIVKA II detection rates: 0/22 (Xa/ec), 1/22 (CIE), 4/22 (MAB); plasma vitamin K-1: undetectable in 20/22. Mothers: Clotting tests all within normal range; PIVKA II detection rates: 1/22 (Xa/ec), 0/22 (CIE), 5/22 (MAB); plasma vitamin K-1 (pg/ml) for all mothers (median; range): 186; 55-833; for PIVKA II positive mothers: 213; 59-699. PIVKA II detectability in newborns and mothers was not correlated. The results show an increase in sensitivity for PIVKA II detection in the order of MAB mchgt CIE gt Xa/ec. Due to the very low plasma vitamin K-1 at birth, no correlation was possible between cord PIVKA II detectability and plasma vitamin K-1. However, in mothers at term PIVKA II MAB appears to be unrelated to the vitamin K status.