Factor II Deficiency Clinical Presentation

Updated: Mar 16, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Perumal Thiagarajan, MD  more...
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Presentation

History

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

  • 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
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Physical

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.

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Causes

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. [46] This novel gain-of-function mutation in the prothrombin gene results in resistance to antithrombin and susceptibility to thrombosis.

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