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Factor II deficiency

Definition

Factor II deficiency is a blood clotting (coagulation) problem that occurs when there is a lack of a substance called prothrombin.

Alternative Names

Hypoprothrombinemia; Prothrombin deficiency

Causes

When you bleed, series of reactions take place in the body that help healthy blood clots form. This is called the coagulation cascade. The process involves special proteins called coagulation or clotting factors. You may have a higher chance of excess bleeding when one or more of these clotting factors are missing.

This disorder occurs when the body does not have enough an important blood clotting protein called factor II. The condition runs in families (inherited) and is very rare. Both parents must have the gene to pass the disorder to their children. A family history of a bleeding disorder can be a risk factor.

Blood clotting

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Blood clotting

Most commonly, factor II deficiency is caused by:

  • Lack of vitamin K due to long-term use of antibiotics, bile duct obstruction, or poor absorption of vitamin K from the intestines. Some babies are born with vitamin K deficiency.
  • Severe liver disease
  • Use of drugs that prevent clotting (anticoagulants such as warfarin or Coumadin)

Symptoms

  • Abnormal bleeding after childbirth
  • Abnormal menstrual bleeding
  • Bleeding after surgery
  • Bleeding after trauma
  • Bruising
  • Nosebleeds
  • Umbilical cord bleeding at birth

Exams and Tests

Treatment

You can control blood loss by getting infusions of fresh or frozen plasma or concentrates of clotting factors into the blood. If a lack of vitamin K is causing the problem, you can take vitamin K by mouth, through injections under the skin, or through a vein (intravenously).

Knowing that you have a bleeding disorder helps the doctor can take extra care if you need surgery. It also lets you alert also tell other family members who may have the same problem.

Support Groups

You can ease the stress of illness by joining a support group [link 091-2204] where members share common experiences and problems.

Outlook (Prognosis)

The outcome can be good with proper treatment.

This is a life-long bleeding disorder if you inherit it the condition.

If it is caused by liver disease, the outcome depends on how well your liver problem can be treated.

Possible Complications

Severe bleeding, even into the brain, 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 can't control the bleeding.

Prevention

Genetic counseling may be helpful for disorders that start at birth (congenital). When a lack of vitamin K is the cause, using vitamin K can help.

References

Ragni MV. Hemorrhagic Disorders: Coagulation Factor Deficiencies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 177.

Gailani D, Neff AT. Rare coagulation factor deficiencies. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 139.


Review Date: 3/3/2013
Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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