NASAL HEMORRHAGE: Studies of Ascorbic Acid, Prothrombin and Vitamin K

Abstract

NOSEBLEED may be due to a large number of widely diversified conditions. Epistaxis is labeled "idiopathic hemorrhage" once the local and systemic causes generally recognized as precipitating or conducive factors are excluded. However, such a "diagnosis" is unsatisfactory and does not lead to causal therapeutic measures. Therefore, it was decided to investigate whether hitherto unrecognized etiologic factors could not be detected. In the course of investigations on the causes of late tonsillar hemorrhage it was demonstrated that prothrombin or ascorbic acid (vitamin C) deficiencies are important contributing factors.¹ These findings prompted us to study ascorbic acid and prothrombin levels in cases of epistaxis. Some workers have casually suggested the administration of ascorbic acid in nosebleed. For instance, Jones² stated that "C [ascorbic acid] may be indicated in some cases of epistaxis," and Nelson³ expressed his "belief" that many cases of nasal hemorrhage "have as their background a subclinical scurvy." However,