Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) is a protein that increases in patients with vitamin K deficiency. It is an earlier and more sensitive marker than the prothrombin time (PT).
PIVKA-II consists of under-gamma-carboxylated forms of prothrombin. Other vitamin K dependent coagulation factors may also have elevated levels of under-gamma-carboxylated forms.
Units for PIVKA-II may be µg/L or AU/mL.
PIVKA-II
Prothrombin Time
Interpretation
normal
normal
adequate vitamin K
elevated
normal
subclinical vitamin K deficiency
elevated
elevated
vitamin K deficiency
normal
elevated
not vitamin K deficient, other cause for elevated PT
PIVKA-II may also be elevated in:
(1) hepatocellular carcinoma
(2) pancreatic carcinoma
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