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-Learn About Coagulation Disorders
-What are Bleeding Disorders?
 History of Bleeding Disorders
-Types of Bleeding Disorders
 Hemophilia A
 Hemophilia B
 von Willebrand Disease
-Other Factor Deficiencies
 Factor I
-Factor II
 Factor V
 Factor VII
 Factor X
 Factor XI
 Factor XII
 Factor XIII
 Types of Bleeds
 Bleeding Disorders and Women
 Caring for the Newly Diagnosed Child
 Psychosocial Issues
 Complications, including Inhibitors
 Future Therapies
 What are Clotting Disorders?
 Comprehensive Medical Care - Hemophilia Treatment Centers
 Medical and Scientific Advisory Council
 Financial and Insurance Issues
 HANDI, NHF's Information Resource Center
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Factor II Deficiency

(Can also be known as prothrombin deficiency)

Factor II deficiency is quite rare, with only 26 cases reported in the medical literature.  The incidence is estimated at 1 in 2 million.  It is inherited in an autosomal recessive fashion, which means it affects men and women equally. 

Prothrombin is a precursor to thrombin, which converts fibrinogen into fibrin which in turn strengthens a protective clot.  Factor II deficiency usually takes the form of an abnormality in the structure of prothrombin rather than a lack of the protein itself.  People with a more severe factor II deficiency have severe bruising, bleeding from the nose and mouth, menorrhagia, as well as muscle bleeds, head bleeds and bleeding after trauma. 
Joint bleeding is rare. 
Diagnosis is made with a prothrombin time (PT) test and an activated partial thromboplastin time (aPTT) test.  Levels of prothrombin deficiency can range from 2% to 50% of normal.  Patients with levels reaching 50% of normal have little to no bleeding problems.  The inherited condition must be distinguished from the acquired form of Factor II, which is also associated with bleeding.  Hereditary Factor II deficiency has also been reported as part of a combined disorder with factor VII, IX, X and protein C and S. 


Moderate bleeding can be treated with Fresh Frozen Plasma.  Correction of prothrombin can also be achieved with the use of Prothrombin complex concentrates (PCCs).  However, there are differences in the amount of factor II present in PCCs, depending upon the product. There are reported risks of thromboembolic complications with certain use of PCCs. 


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