Factor II Deficiency Treatment & Management

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

Treatment of factor II deficiency should be individualized and aimed at restoring circulating factor II to levels sufficient for hemostasis. Levels greater than 30% of normal are usually adequate. Additionally, in patients with acquired factor II deficiency, the underlying cause should be found and treated.

Treatment options include the following:

  • Infusion of fresh frozen plasma (FFP) is usually sufficient to treat most cases of bleeding; a loading intravenous (IV) dose of 15-20 mL/kg is administered, followed by a maintenance dose of 3-6 mL/kg IV q12-24 h

  • Plasma exchange transfusion may be used to increase factor II levels before surgery

  • Prothrombin complex concentrates (PCCs) have also been used to increase factor II levels [47] ; PCCs contain factors II, VII, IX, and X, along with protein C; however, PCCs should be used judiciously because of the risk of thromboembolic complications

  • Vitamin K administration may be useful in patients with acquired factor II deficiency

Consultations to consider in cases of factor II deficiency include hematologists and, in patients with congenital factor II deficiency, genetic counselors.


Diet and Activity

No dietary restrictions are necessary in individuals with factor II deficiency. Patients should be advised to limit consumption of alcohol to reduce the risk of alcohol-induced liver disease.

Activity should be regulated based on the severity of the factor II deficiency and the presence or absence of symptoms. Because of the risk of hemorrhage following traumatic injury, activities with high levels of physical contact are not recommended.