Prothrombin (Factor II) Deficiency – Acquired

At a Glance

Acquired isolated factor II deficiency is associated with factor II inhibitors.

Based on their effect on prothrombin time (PT), partial thromboplastin time (PTT), and 1:1 mixing study, factor II inhibitors may be non-neutralizing or neutralizing.

What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?

The following test results are consistent with acquired isolated factor to deficiency.

For non-neutralizing antibodies to factor to which increase the clearance rate of prothrombin and are usually associated with lupus anticoagulant and bleeding:

  • Prolonged PT and PTT

  • Correction of 1:1 mixing study for the PT and PTT

  • Isolated decrease of factor II activity

For neutralizing antibodies that are associated either with bleeding or with recurrent arterial thrombosis:

  • Prolonged PT and PTT

  • Noncorrection of 1:1 mixing study for the PT and PTT

  • Isolated decrease of factor II activity

Are There Any Factors That Might Affect the Lab Results? In particular, does your patient take any medications - OTC drugs or Herbals - that might affect the lab results?

Acquired prothrombin deficiency is seen in patients with liver disease, vitamin K deficiency (malnutrition, antibiotics), or ingestion of vitamin K antagonists, such as warfarin or superwarfarins. In all of these conditions, all vitamin K-dependent factors, including protein C and protein S, are decreased.

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