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Seyed Mehrab Safdari: Unmasking Factor VII Padua to Prevent Unnecessary Therapy and Thrombotic Risk

Seyed Mehrab Safdari/LinkedIn

Sep 3, 2026, 06:27

Seyed Mehrab Safdari: Unmasking Factor VII Padua to Prevent Unnecessary Therapy and Thrombotic Risk

Seyed Mehrab Safdari, Molecular Laboratory Technician at Tehran University of Medical Sciences, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Haemophilia, adding:

“Thrombosis in a rare bleeding disorder?!

This paradox was one of the most intriguing aspects of my MSc thesis, where I investigated Factor VII Padua, an ultra-rare subtype of type II Factor VII deficiency caused by the F7 c.1091G>A (p.Arg364Gln) variant.

FVII Padua presents several diagnostic challenges:

FVII activity is highly thromboplastin-dependent. Rabbit-brain thromboplastin may show severely reduced activity, while human-placental or recombinant human thromboplastins can yield substantially higher values.
The clinical phenotype is highly variable, ranging from asymptomatic individuals to patients with mild or moderate bleeding.
Thrombosis can occur despite markedly reduced FVII activity, making accurate diagnosis particularly important.

In our cohort of 150 Iranian patients with FVII deficiency, 13 (8.6%) showed PT patterns suggestive of FVII Padua. HRM identified 9 heterozygous and 2 homozygous cases, while sequencing confirmed the p.Arg364Gln variant in 2 patients. Four additional exon 9 variants were also identified.

The confirmed Padua cases showed diverse clinical manifestations, including bruising, epistaxis, gastrointestinal bleeding, and gum bleeding.

Therefore,accurate recognition of FVII Padua is essential because thromboplastin-dependent laboratory results may complicate diagnosis and potentially lead to unnecessary replacement therapy and increased thrombotic risk.

This project reinforced an important lesson in haemostasis:

A very low factor level does not always tell the whole story.”

Title: Factor VII Padua in Iran: A Study on 150 Patients With Factor VII Deficiency

Authors: Seyed Mehrab Safdari, Mahmood Barati, Soudabeh Hosseini, Ebrahim Kalantar, Farhad Zaker, Akbar Dorgalaleh

Seyed Mehrab Safdari