Factor II 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.
Hypoprothrombinemia; Prothrombin deficiency
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
- Use of medicines that prevent clotting (anticoagulants such as warfarin)
Symptoms may include any of the following:
- Abnormal bleeding after childbirth
- Heavy menstrual bleeding
- Bleeding after surgery
- Bleeding after trauma
- Bruising easily
- Nosebleeds that do not stop easily
- Umbilical cord bleeding after birth
Exams and Tests
Tests that may be done include:
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.
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
National Hemophilia Foundation: Victory for Women with Blood Disorders -- www.hemophilia.org/Community-Resources/Women-with-Bleeding-Disorders/Victory-for-Women-with-Blood-Disorders
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.
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.
There is no known prevention for inherited factor II deficiency. When a lack of vitamin K is the cause, using vitamin K can help.
Bauer KA, Sharda AV. Rare hereditary coagulation factor abnormalities. In: Orkin SH, Fisher DE, Ginsburg D, Look AT, Lux SE, Nathan DG, eds. Nathan and Oski's Hematology and Oncology of Infancy and Childhood. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 32.
Hall JE. Hemostasis and blood coagulation. In: Hall JE, ed. Guyton and Hall Textbook of Medical Physiology. 13th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 37.
Ragni MV. Hemorrhagic disorders: coagulation factor deficiencies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 174.
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.