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Factor II deficiency
Hypoprothrombinemia; Prothrombin deficiency
Factor II (two) deficiency is a disorder caused by a lack of a protein called factor II in the blood. It leads to problems with blood clotting (coagulation). Factor II is also known as prothrombin.
Causes
When you bleed, a series of reactions take place in the body that helps blood clots form. This process is called the coagulation cascade. It involves special proteins called coagulation, or clotting, factors. You may have a higher chance of excess bleeding if one or more of these factors are missing or are not functioning like they should.
Factor II is one such coagulation factor. Factor II deficiency runs in families (inherited) and is very rare. Both parents must have the gene to pass the disorder on to their children. A family history of a bleeding disorder can be a risk factor.
Factor II deficiency can also be due to another condition or use of certain medicines. This is called acquired factor II deficiency. It can be caused by:
- Lack of vitamin K (some babies are born with vitamin K deficiency)
-
Severe
liver disease
Liver disease
The term "liver disease" applies to many conditions that stop the liver from working or prevent it from functioning well. Abdominal pain, yellowing ...
ImageRead Article Now Book Mark Article - Use of medicines that prevent clotting (anticoagulants such as warfarin)
Symptoms
Symptoms may include any of the following:
- Abnormal bleeding after childbirth
- Heavy menstrual bleeding
- Bleeding after surgery
- Bleeding after trauma
-
Bruising
easily
Bruising
Bleeding into the skin can occur from broken blood vessels that form tiny red dots (called petechiae). Blood also can collect under the tissue in la...
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Nosebleeds
that do not stop easily
Nosebleeds
A nosebleed is loss of blood from the tissue lining the nose. Bleeding most often occurs in 1 nostril only.
ImageRead Article Now Book Mark Article - Umbilical cord bleeding after birth
Exams and Tests
Tests that may be done include:
-
Factor II assay
Factor II assay
The factor II assay is a blood test to measure the activity of factor II. Factor II is also known as prothrombin. This is one of the proteins in th...
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Partial thromboplastin time
Partial thromboplastin time
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem...
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Prothrombin time (
PT
)
PT
Prothrombin time (PT) is a blood test that measures the time it takes for the liquid portion (plasma) of your blood to clot. A related blood test is ...
Read Article Now Book Mark Article - Mixing study
Treatment
Bleeding can be controlled by getting intravenous (IV) infusions of plasma or concentrates of clotting factors. If you lack vitamin K, you can take this vitamin by mouth, through injections under the skin, or through a vein (intravenously).
If you have this bleeding disorder, be sure to:
- Tell your health care providers before you have any kind of procedure, including surgery and dental work.
- Tell your family members because they may have the same disorder but do not know it yet.
Support Groups
Find out more about bleeding disorders through these groups:
American Society of Hematology -- www.hematology.org/Patients/Blood-Disorders.aspx
National Hemophilia Foundation: Other Factor Deficiencies -- www.hemophilia.org/Bleeding-Disorders/Types-of-Bleeding-Disorders/Other-Factor-Deficiencies
Victory for Women with Blood Disorders -- www.hemophilia.org/Community-Resources/Women-with-Bleeding-Disorders/Victory-for-Women-with-Blood-Disorders
Outlook (Prognosis)
The outcome is good with proper treatment.
Inherited factor II deficiency is a lifelong condition.
The outlook for acquired factor II deficiency depends on the cause. If it is caused by liver disease, the outcome depends on how well your liver disease can be treated. Taking vitamin K supplements will treat vitamin K deficiency.
Possible Complications
Severe bleeding in the organs can occur.
When to Contact a Medical Professional
Get emergency treatment right away if you have unexplained or long-term blood loss, or if you cannot control the bleeding.
Prevention
There is no known prevention for inherited factor II deficiency. When a lack of vitamin K is the cause, using vitamin K can help.
References
Gailani D, Neff AT. Rare coagulation factor deficiencies. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, Anastasi JI, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 139.
Ragni MV. Hemorrhagic disorders: coagulation factor deficiencies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 177.
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Blood clot formation - illustration
Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.
Blood clot formation
illustration
-
Blood clots - illustration
Blood clots (fibrin clots) are the clumps that result when blood coagulates.
Blood clots
illustration
-
Blood clot formation - illustration
Blood clotting normally occurs when there is damage to a blood vessel. Platelets immediately begin to adhere to the cut edges of the vessel and release chemicals to attract even more platelets. A platelet plug is formed, and the external bleeding stops. Next, small molecules, called clotting factors, cause strands of blood-borne materials, called fibrin, to stick together and seal the inside of the wound. Eventually, the cut blood vessel heals and the blood clot dissolves after a few days.
Blood clot formation
illustration
-
Blood clots - illustration
Blood clots (fibrin clots) are the clumps that result when blood coagulates.
Blood clots
illustration
Review Date: 1/22/2015
Reviewed By: Rita Nanda, MD, Assistant Professor of Medicine, Section of Hematology/Oncology, University of Chicago Medicine, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
