Vitamin K deficiency, liver disease and disseminated intravascular coagulation (DIC) are common causes of bleeding, and distinguishing between them is a common problem for physicians. Measuring levels of Factors V and VII can be helpful in separating between these conditions.

Factor V Level

Factor VII Level




vitamin K deficiency; isolated deficiency Factor VII (rare)


normal (or higher than Factor V)

DIC; isolated deficiency Factor V (rare)



liver dysfunction



platelet or vascular defect; Hemophilia A or B; von Willebrand's disease


Features of Vitamin K deficiency:

(1) Factors 2, 9 and 10 also decreased

(2) response to vitamin K


Features of DIC (with consumption of coagulation factors):

(1) fibrin degradation products

(2) usually thrombocytopenia

(3) usually reduced fibrinogen (may be masked if previously increased levels)

(4) no response to vitamin K


Features of liver dysfunction (with generalized deficiency of coagulation factors):

(1) abnormal liver function tests

(2) no response to vitamin K administration


Limitation: For optimum benefit of this algorithm, coagulation factor levels need to be readily available. This is unlikely in clinics or small hospitals, whereas platelet counts, fibrin degradation products and liver function tests are more readily available.


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