Hemolysis, menadione

These compounds may also interfere with bile pigment. secretion. Newborns with a congenital defect of gIucose-6-phosphate dehydrogenase can react with severe hemolysis, even to. small doses of menadione derivmives.. Small nonhe-molyzing dases. however, can be used in the newborn, and a combination with vitamin E is not considered essential. ... 

The use of high doses of naturally occurring vitamin K (Kj and K2) appears to have no untoward effect however, menadione (K3) treatment can lead to the formation of erythrocyte cytoplasmic inclusions known as Heinz bodies and hemolytic anemia. With severe hemolysis, increased bilirubin formation and undeveloped capacity for its conjugation may produce kernicterus in the newborn. 

The hemolytic effect of menadione may be demonstrated also in vitro with red blood cells obtained from vitamin E-deficient rats (Rose and Gyorgy, 1960). This was first shown in vivo by Allison el al. (1956). The tetrasodium salt of the diphosphoric acid ester of 2-methyl-l, 4-naphthohydroquinone (Synkayvite ) was inactive in vitro but produced hemolysis after pretreatment with phosphatase (Rose and Gyorgy, 1960). The natural vitamin Ki was inactive in vivo as well as in vitro. Vitamin E prevents the hemolysis by vitamin K derivatives. In agreement with Nitowsky and Marks, it is... 

Water-soluble menadione can produce anemia, skin irritation, polycythemia, splenomegaly, renal and hepatic damage, and death. Also implicated in hemolytic anemia, hyperbilirubinemia, and kernicterus. Menadione can induce erythrocyte hemolysis in individuals with genetic defect in glucose-6-phosphate dehydrogenase. 

---