In synchronization with the tissue factor, factor VII helps in the process of coagulation. Tissue factor is normally not exposed to the blood vessels. On injury to the blood vessels, the tissue factor is exposed to factor VII which then through the complex process results in coagulation of blood. Deficiency of this clotting factor results in bleeding. What causes the coagulation is still not known. It is said to be an inherited disorder. Certain hepatotoxic drugs, aspirin, or blood thinning products, etc., can also contribute to the deficiency. Deficiency of vitamin K and liver diseases can also lead to factor VII deficiency.
Symptoms
Factor VII deficiency is characterized by bleeding from nose or in between “nose bleeding and gum bleeding” can be seen. They can complain of recurrent pain in the joints, swelling, and can experience difficulty in motion. Bleeding in joint spaces is seen which can cause either discomfort or pain. Minor cuts or wounds can bleed profusely, Profuse bleeding can occur during a surgical resection. Easy skin bruising occurs. Hematuria, hemoptysis, or hematemesis can occur. In severe cases, intracranial hemorrhages can occur, giving rise to a variety of complaints.
Investigations and diagnosis
The diagnosis is done on the basis of the symptoms narrated by the patient and investigations advised. Routine blood test along with activated partial thromboplastin time test, prothrombin time test, and thrombin time test are advised. Blood test for measuring the levels of factor VII is diagnostic.
Treatment
Usually a patient with mild deficiency may not show any symptoms, hence in such cases intervention is not needed. Moderate deficiency is treated with replacement of the factor VII. Intravenous injections are administered. Fresh frozen plasma can also be used for treating these patients. In severe cases, systemic attention and hospitalization is needed. In cases of acute injury to the joint or affected part, RICE method is adopted (rest, ice application, compression, and elevation). Medications like antifibrinolytic agents or desmopressin acetate is given, which a person suffering from this deficiency should store or carry with them for use in case of emergencies. Synthetic hormonal preparation has replaced the use of old frozen plasma powders. Newer medications or drugs are also available in mild cases.
Facts and Figures:
The incidence of this rare bleeding disorder is 1 in 300,000-500,000 people.
