Factor V Deficiency

Differential Diagnosis

Typically, FV deficiency is first suspected in a patient with bleeding symptoms who has a prolongation of both the prothrombin time and the partial thromboplastin time. If a low FV activity is discovered, then congenital FV deficiency must be distinguished from consumptive coagulopathy, liver disease, combined FV and FVIII deficiencies, and an acquired FV inhibitor.

The clinical setting is often sufficient to differentiate FV deficiency from disseminated intravascular coagulation or liver disease, but testing for d-dimers, fibrinogen level, and liver dysfunction or damage may be useful. A FVIII level is necessary to distinguish isolated FV deficiency from the combined deficiency of FV and FVIII and may help in distinguishing congenital FV deficiency from that owing to liver failure, as FVIII levels are often elevated in liver dysfunction.

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