Acquired Isolated FVII Deficiency: An Underestimated and Potentially Important Laboratory Finding.
OBJECTIVE
To investigate all cases of isolated factor VII (FVII) deficiency as gathered from personal files or by a PubMed search.


METHODS
Personal files dealing with patients studied in Padua during the years 1970 to 2010 were reevaluated. The PubMed search was time unlimited and was carried on 2 occasions during 2014. Cross-checking of the references, listed in every article, was also carried out to avoid omissions. Inclusion criteria were isolated FVII defect of less than 40% of normal, negative coagulation pattern in the family, normal level of other vitamin K-dependent clotting factors, and normalization of the clotting factor after the therapeutic procedures, unless the patient died.


RESULTS
Twenty-nine patients met the inclusion criteria (18 male and 9 female, in 2 cases gender was unreported). This number included 1 personal case. Mean age was 37.9 (range 3-80). Underlying diseases were the following: neoplasia, infections, polytrauma, penicillin administration, nephrotic syndrome Wiskott Aldrich syndrome, and left heart failure (1 case, each); 2 patients had no underlying disease. Bleeding was variable but usually mild. There were 11 fatalities.


CONCLUSIONS
Isolated FVII deficiency is a rare defect, which appears to be a finding associated with several morbid conditions, especially sepsis and tumors. This indicates the need for a careful investigation of even a mild prolongation of prothrombin time, especially when fibrinogen and partial thromboplastin time are normal.
Department of Medicine, University of Padua Medical School, Padua, Italy antonio.girolami@unipd.it.
Antonio
A
Girolami
Department of Medicine, University of Padua Medical School, Padua, Italy.
Claudia
C
Santarossa
Department of Medicine, University of Padua Medical School, Padua, Italy.
Elisabetta
E
Cosi
Department of Medicine, University of Padua Medical School, Padua, Italy.
Silvia
S
Ferrari
Department of Medicine, University of Padua Medical School, Padua, Italy.
Anna Maria
AM
Lombardi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005168:Factor VII Deficiency / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
acquired deficiency; factor VII; neoplasia; prognosis; sepsis