{"id":3954,"date":"2023-09-29T20:56:11","date_gmt":"2023-09-29T20:56:11","guid":{"rendered":"https:\/\/cafeprosaedicas.com.br\/?p=3954"},"modified":"2023-09-29T20:58:03","modified_gmt":"2023-09-29T20:58:03","slug":"deficiencia-de-g6pd-toda-vitamina-k-e-restrita","status":"publish","type":"post","link":"https:\/\/cafeprosaedicas.com.br\/?p=3954","title":{"rendered":"Defici\u00eancia de G6PD: Toda Vitamina k \u00e9 restrita?"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"3954\" class=\"elementor elementor-3954\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-926cec4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"926cec4\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-288341a\" data-id=\"288341a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a842957 elementor-widget elementor-widget-heading\" data-id=\"a842957\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Defici\u00eancia de G6PD: Toda Vitamina k \u00e9 restrita?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9c7bcf9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9c7bcf9\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4ef1fef\" data-id=\"4ef1fef\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f0b17cb elementor-widget elementor-widget-text-editor\" data-id=\"f0b17cb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Ol\u00e1 fam\u00edlia G6PD!<\/p><p>Hoje vamos falar sobre a restri\u00e7\u00e3o da Vitamina k, trouxe um resumo de um dos estudos que deixa bem claro essa quest\u00e3o. O estudo \u00e9 muito longo e em ingl\u00eas, ent\u00e3o traduzi uma parte e trouxe o resumo final do mesmo para que todos possam entender.<\/p><p>Antes da leitura do estudo, vou facilitar as nossas vidas e j\u00e1 responder a nossa quest\u00e3o, a restri\u00e7\u00e3o da Vitamina k se deu por muito tempo por suspeitas dela ser indutora de hemolise, por\u00e9m n\u00e3o a simples vitamina k dos alimentos ou dos suplementos vitaminicos, mas sim a vitamina k administrada nos rec\u00e7em nascidos na maternidade, temos outros textos aqui no site falando sobre isso.<\/p><p>A vitamina k em alimentos ou em suplementos vitaminicos na realidade nunca foi restrita, e continua n\u00e3o sendo. Realmente a maior preocupa\u00e7\u00e3o \u00e9 a Vitamina k ministrada na maternidade, que ainda sim \u00e9 aplicada dita hoje por muitos estudos como segura para Deficientes da enzima G6PD. E ainda que fosse restrita continua sendo ministrada entrando como risco x beneficios.<\/p><p>Ao ler o resumo desse estudo voc\u00ea ir\u00e1 compreender que n\u00e3o existe restri\u00e7\u00e3o para vitamina k em alimentos ou em suplementos, sendo assim n\u00e3o existe necessidade de restringir um suplemento vitaminico que contenha alguma dose de vitamina k, caso seu uso seja necessario.<\/p><div class=\"t m0 x0 h1 y0 ff1 fs0 fc0 sc0 ls0 ws0\">Effect of vitamin K1 on glucose-6-phosphate<\/div><div class=\"t m0 x0 h1 y1 ff1 fs0 fc0 sc0 ls0 ws0\">dehydrogenase de\ufb01cient neonatal erythrocytes<\/div><div class=\"t m0 x0 h1 y2 ff1 fs0 fc0 sc0 ls0 ws0\">in vitro<\/div><div class=\"t m0 x0 h2 y3 ff1 fs1 fc0 sc0 ls0 ws0\">Michael Kaplan, Dan Waisman, Dalia Mazor, Cathy Hammerman, David Bader,<\/div><div class=\"t m0 x0 h2 y4 ff1 fs1 fc0 sc0 ls0 ws0\">Ayala Abrahamov, Naomi Meyerstein<\/div><p>\u201cQuando a profilaxia com vitamina K foi introduzida pela primeira vez, foi utilizada a menadiona sol\u00favel em \u00e1gua (vitamina K3). Esta prepara\u00e7\u00e3o de vitaminas pode ser um forte oxidante. A administra\u00e7\u00e3o de altas doses desse medicamento, tanto em rec\u00e9m-nascidos quanto em mulheres gr\u00e1vidas, esteve associada ao desenvolvimento de hem\u00f3lise severa, hiperbilirrubinemia e c\u00e2ncer, principalmente em prematuros.<\/p><p>Os neonatos deficientes em G-6-PD estavam em maior risco para o desenvolvimento dessas complica\u00e7\u00f5es. A administra\u00e7\u00e3o do vitamina K1 sol\u00favel em gordura n\u00e3o estava associado a essas complica\u00e7\u00f5es e agora \u00e9 a forma recomendada da vitamina. Usando um m\u00e9todo in vitro, Shahal e cols.17 estudaram o eVect de vitamina K3 e K1 em G-6-PD normal neonatal eritr\u00f3citos. A vitamina K3, quando incubada com eritro-rocitos, causou danos oxidativos, como evidenciado pelo aumento do conte\u00fado de metahemoglobina e pela deple\u00e7\u00e3o de GSH. Por outro lado, a vitamina K1 n\u00e3o causou esses efeitos, ap\u00f3s a incuba\u00e7\u00e3o in vitro ou ap\u00f3s a administra\u00e7\u00e3o terap\u00eautica.<\/p><p>A vitamina K1 \u00e9 administrada com seguran\u00e7a tanto a G-6-PD normal quanto deficiente por muitos anos, e n\u00e3o tem sido implicada como causa de hem\u00f3lise importante. capacidade antioxidante das c\u00e9lulas neonatais normais G-6-PD,\u00a0 est\u00e1vamos preocupados a vitamina K1 pode possivelmente causar danos oxidativos nas c\u00e9lulas deficientes em G-6-PD e, portanto, ser respons\u00e1vel pela hem\u00f3lise de baixo grau documentada nesses neonatos.\u00a0 Seria interessante ter realizado um estudo controlado e invivo do efeito da vitamina\u00a0 K1 de rec\u00e9m-nascidos deficientes em G-6-PD. No entanto, como os rec\u00e9m-nascidos deficientes em G-6-PD\u00a0 toleram profilaxia com vitamina K1 sem evid\u00eancia evidente de hem\u00f3lise grave e, como a reten\u00e7\u00e3o da vitamina K1 pode estar associada a hemorragia com risco de vida, n\u00e3o \u00e9 poss\u00edvel justificar eticamente o atraso na administra\u00e7\u00e3o de vitamina K1 para fins.\u00a0 Foram estudados v\u00e1rios sistemas in vitro para testar o efeito hemol\u00edtico de drogas em c\u00e9lulas sangu\u00edneas deficientes em G-6-PD, para tentar imitar a situa\u00e7\u00e3o in vivo.<\/p><p>Os resultados de nosso estudo sugerem que a vitamina K1 n\u00e3o causa dano oxidativo significativamente maior nas c\u00e9lulas sangu\u00edneas vermelhas deficientes em G-6-PD do que nos controles, e que a hem\u00f3lise aumentada encontrada nos neonatos deficientes em G-6-PD n\u00e3o pode ser atribu\u00edda a rotina de administra\u00e7\u00e3o de vitamina K1\u201d<\/p><p><strong>Refer\u00eancias:<\/strong><\/p><div class=\"t m0 x24 h9 y153 ff1 fs5 fc0 sc0 ls0 ws0\">Valaes T. Severe neonatal jaundice associated with glucose-<\/div><div class=\"t m0 x25 h9 y154 ff1 fs5 fc0 sc0 ls0 ws0\">6-phosphate dehydrogenase de\ufb01ciency: pathogenesis and<\/div><div class=\"t m0 x25 h9 y155 ff1 fs5 fc0 sc0 ls0 ws0\">global epidemiology.<span>\u00a0<\/span><span class=\"ff7\">Acta Paediatr<span>\u00a0<\/span><\/span><span class=\"ls3\">1994;Suppl<span>\u00a0<\/span><span class=\"ff3\">394<\/span>:58-76.<\/span><\/div><div class=\"t m0 x24 h9 y156 ff1 fs5 fc0 sc0 ls0 ws0\">2 Kaplan M, Abramov A. Neonatal hyperbilirubinemia<\/div><div class=\"t m0 x26 h9 y157 ff1 fs5 fc0 sc0 ls0 ws0\">associated with glucose-6-phosphate dehydrogenase de\ufb01-<\/div><div class=\"t m0 x26 h9 y158 ff1 fs5 fc0 sc0 ls0 ws0\">ciency in Sephardic-Jewish infants: incidence, severity and<\/div><div class=\"t m0 x26 h9 y159 ff1 fs5 fc0 sc0 ls3 ws0\">the e<span class=\"ff2\">V<\/span>ect of phototherapy.<span>\u00a0<\/span><span class=\"ff7 ls0\">Pediatrics<span>\u00a0<\/span><span class=\"ff1 ls3\">1992;<span class=\"ff3\">90<\/span>:401-5.<\/span><\/span><\/div><div class=\"t m0 x24 h9 y15a ff1 fs5 fc0 sc0 ls0 ws0\">3 Kaplan M, Vreman HJ, Hammerman C, Leiter C, Abramov<\/div><div class=\"t m0 x26 h9 y15b ff1 fs5 fc0 sc0 ls0 ws0\">A, Stevenson DK. Contribution of haemolysis to jaundice<\/div><div class=\"t m0 x26 h9 y15c ff1 fs5 fc0 sc0 ls0 ws0\">in Sephardic Jewish glucose-6-phosphate dehydrogenase<\/div><div class=\"t m0 x26 h9 y15d ff1 fs5 fc0 sc0 ls0 ws0\">de\ufb01cient neonates.<span>\u00a0<\/span><span class=\"ff7 ls3\">Br J Haematol<span>\u00a0<\/span><span class=\"ff1\">1996;<span class=\"ff3\">93<\/span>:822-7<\/span><\/span><\/div><div class=\"t m0 x26 h9 y15d ff1 fs5 fc0 sc0 ls0 ws0\"><\/div><div><\/div><div><\/div><div class=\"sharedaddy sd-sharing-enabled\"><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-dcb6c50 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"dcb6c50\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f26b31b\" data-id=\"f26b31b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-591e279 elementor-widget elementor-widget-text-editor\" data-id=\"591e279\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"t m0 x26 h9 y15d ff1 fs5 fc0 sc0 ls0 ws0\">Em breve trarei mais estudos cientificos para voc\u00eas. E como podem ver a preocupa\u00e7\u00e3o com a vitamina k era na sua forma intravenoso, ou seja, sua ingest\u00e3o seja por alimento ou suplemento vitaminico nunca nem foi citado em estudos, pois nunca houve rela\u00e7\u00e3o de hemolise a estas formas de ingest\u00e3o.<\/div><div class=\"t m0 x26 h9 y15d ff1 fs5 fc0 sc0 ls0 ws0\"><\/div><div class=\"sharedaddy sd-sharing-enabled\"><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Defici\u00eancia de G6PD: Toda Vitamina k \u00e9 restrita? Ol\u00e1 fam\u00edlia G6PD! Hoje vamos falar sobre a restri\u00e7\u00e3o da Vitamina k, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":3955,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[225],"tags":[29,32,31,30],"class_list":["post-3954","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-artigos-cientificos","tag-deficiencia-de-g6pd","tag-dicas-g6pd","tag-g6pd-informacao","tag-maes-g6pd"],"uagb_featured_image_src":{"full":["https:\/\/cafeprosaedicas.com.br\/wp-content\/uploads\/2023\/09\/abstract-luminous-dna-molecule-doctor-260nw-1395147236-e1696020967404.webp",287,261,false],"thumbnail":["https:\/\/cafeprosaedicas.com.br\/wp-content\/uploads\/2023\/09\/abstract-luminous-dna-molecule-doctor-260nw-1395147236-e1696020967404-150x150.webp",150,150,true],"medium":["https:\/\/cafeprosaedicas.com.br\/wp-content\/uploads\/2023\/09\/abstract-luminous-dna-molecule-doctor-260nw-1395147236-300x158.webp",300,158,true],"medium_large":["https:\/\/cafeprosaedicas.com.br\/wp-content\/uploads\/2023\/09\/abstract-luminous-dna-molecule-doctor-260nw-1395147236-e1696020967404.webp",287,261,false],"large":["https:\/\/cafeprosaedicas.com.br\/wp-content\/uploads\/2023\/09\/abstract-luminous-dna-molecule-doctor-260nw-1395147236-e1696020967404.webp",287,261,false],"1536x1536":["https:\/\/cafeprosaedicas.com.br\/wp-content\/uploads\/2023\/09\/abstract-luminous-dna-molecule-doctor-260nw-1395147236-e1696020967404.webp",287,261,false],"2048x2048":["https:\/\/cafeprosaedicas.com.br\/wp-content\/uploads\/2023\/09\/abstract-luminous-dna-molecule-doctor-260nw-1395147236-e1696020967404.webp",287,261,false]},"uagb_author_info":{"display_name":"Nilza","author_link":"https:\/\/cafeprosaedicas.com.br\/?author=1"},"uagb_comment_info":1,"uagb_excerpt":"Defici\u00eancia de G6PD: Toda Vitamina k \u00e9 restrita? Ol\u00e1 fam\u00edlia G6PD! Hoje vamos falar sobre a restri\u00e7\u00e3o da Vitamina k, [&hellip;]","_links":{"self":[{"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=\/wp\/v2\/posts\/3954","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3954"}],"version-history":[{"count":4,"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=\/wp\/v2\/posts\/3954\/revisions"}],"predecessor-version":[{"id":3959,"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=\/wp\/v2\/posts\/3954\/revisions\/3959"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=\/wp\/v2\/media\/3955"}],"wp:attachment":[{"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3954"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3954"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cafeprosaedicas.com.br\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3954"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}