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Factor II Deficiency Clinical Presentation

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Perumal Thiagarajan, MD  more...
Updated: Jun 16, 2016


Patients with a factor II deficiency may report a family history of bleeding disorders. They may also report a history of the following symptoms:

  • Umbilical cord stump bleeding at birth
  • Prolonged bleeding following circumcision
  • Easy bruising
  • Bleeding gums
  • Epistaxis
  • Menorrhagia
  • Prolonged postsurgical bleeding
  • Melena
  • Hemarthroses
  • Soft-tissue hemorrhages
  • Intracranial bleeding


The physical examination of a patient with factor II deficiency may reveal petechiae and/or ecchymoses, which commonly develop in areas of minor trauma. Ambulatory patients may have petechiae or ecchymoses in the ankle area, whereas bedridden patients may have them on the back. Petechiae may develop following blood pressure measurements in the area beneath the cuff. Additionally, patients may ooze from venipuncture sites. Patients with active hemorrhage may also be seen in emergency departments.

In the case of acquired factor II deficiency, physical examination may reveal signs of underlying liver disease or gastrointestinal malabsorption.



See the list below:

  • Inherited factor II deficiency is an autosomal recessive disorder.
  • The most common causes of acquired factor II deficiency include severe liver disease, vitamin K deficiency, or vitamin K antagonist administration (eg, warfarin).
  • Hereditary thrombosis associated with antithrombin resistance may result from a mutation in the gene encoding prothrombin.[44] This novel gain-of-function mutation in the prothrombin gene results in resistance to antithrombin and susceptibility to thrombosis.
Contributor Information and Disclosures

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.


Pere Gascon, MD, PhD Professor and Director, Division of Medical Oncology, Institute of Hematology and Medical Oncology, IDIBAPS, University of Barcelona Faculty of Medicine, Spain

Pere Gascon, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, New York Academy of Medicine, New York Academy of Sciences, Sigma Xi

Disclosure: Nothing to disclose.

Christopher J Steen, MD Dermatologist, Private Practice

Christopher J Steen, MD is a member of the following medical societies: Alpha Omega Alpha, Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ronald A Sacher, MB, BCh, FRCPC, DTM&H Professor, Internal Medicine and Pathology, Director, Hoxworth Blood Center, University of Cincinnati Academic Health Center

Ronald A Sacher, MB, BCh, FRCPC, DTM&H is a member of the following medical societies: American Association for the Advancement of Science, American Association of Blood Banks, American Society for Clinical Pathology, American Society of Hematology, College of American Pathologists, International Society on Thrombosis and Haemostasis, Royal College of Physicians and Surgeons of Canada, American Clinical and Climatological Association, International Society of Blood Transfusion

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: GSK Pharmaceuticals,Alexion,Johnson & Johnson Talecris,,Grifols<br/>Received honoraria from all the above companies for speaking and teaching.

Chief Editor

Perumal Thiagarajan, MD Professor, Department of Pathology and Medicine, Baylor College of Medicine; Director, Transfusion Medicine and Hematology Laboratory, Michael E DeBakey Veterans Affairs Medical Center

Perumal Thiagarajan, MD is a member of the following medical societies: American College of Physicians, American Society for Clinical Investigation, Association of American Physicians, American Society for Biochemistry and Molecular Biology, American Heart Association, American Society of Hematology, Royal College of Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Paul Schick, MD Emeritus Professor, Department of Internal Medicine, Jefferson Medical College of Thomas Jefferson University; Research Professor, Department of Internal Medicine, Drexel University College of Medicine; Adjunct Professor of Medicine, Lankenau Hospital

Paul Schick, MD is a member of the following medical societies: American College of Physicians, American Society of Hematology

Disclosure: Nothing to disclose.

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