The severe adverse reaction to vitamin k1 injection is anaphylactoid reaction but not anaphylaxis

The severe adverse reaction to vitamin K₁ injection is always remarkable and is thought to result from anaphylaxis. Paradoxically, however, some patients administered vitamin K₁ injection for the first time have adverse reactions. Using beagle dogs, the present study tested the hypothesis that the response to vitamin K₁ is an anaphylactoid reaction. The results showed that serious anaphylaxis-like symptoms appeared in beagle dogs after the administration of vitamin K₁ injection for the first time. The plasma histamine concentration increased, and blood pressure decreased sharply. After sensitization, dogs were challenged with vitamin K₁ injection and displayed the same degree of symptoms as prior to sensitization. However, when the vitamin K₁ injection-sensitized dogs were challenged with a vitamin K₁-fat emulsion without solubilizers such asTween-80, the abnormal reactions did not occur. Furthermore, there was no significant change in the plasma immunoglobulin E concentration after vitamin K₁ challenge. Following treatment with vitamin K₁ injection, the release of histamine and β-hexosaminidase by rat basophilic leukemia-2H3 cells as well as the rate of apoptosis increased. The Tween-80 group displayed results similar to those observed following vitamin K₁ injection in vivo. However, the dogs in the vitamin K₁-fat emulsion group did not display any abnormal behavior or significant change in plasma histamine. Additionally, degranulation and apoptosis did not occur in rat basophilic leukemia-2H3 cells. Our results indicate that the adverse reaction induced by vitamin K₁ injection is an anaphylactoid reaction, not anaphylaxis. Vitamin K₁ injection induces the release of inflammatory factors via a non-IgE-mediated immune pathway, for which the trigger may be the solubilizer.