A newborn baby has multiple hemorrhages. Clotting studies demonstrate an elevated prothrombin time. An abnormality of which of the following biochemical processes is likely present in this patient?
Deficiency of vitamin K produces a clotting disorder characterized by an elevated prothrombin time and easy bleeding, paicularly in neonates (hemorrhagic disease of the newborn). The biochemical basis for this hemorrhagic tendency is that glutamate residues on Factors II (Thrombin), VII, IX, and X must be conveed to gamma-carboxyglutamate residues (in a vitamin K-requiring reaction) for optimal activity. The conversion of homocysteine to methionine requires vitamin B12. Conversion of methylmalonyl CoA to succinyl CoA requires vitamin B12. Degradation of cystathionine requires vitamin B6. Ref: Bender D.A. (2011). Chapter 44. Micronutrients: Vitamins & Minerals. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
Conversion of homocysteine to methionine
Conversion of methylmalonyl CoA to succinyl CoA
Degradation of cystathionine
Formation of gamma-carboxyglutamate residues