Zahra Safarzadeh: When Low Factor VII Activity and Reduced VWF Antigen Coexist
Zahra Safarzadeh, Clinical Laboratory Scientist at Shahid Dastgheib Hospital, Shiraz University of Medical Sciences, shared a post on LinkedIn:
”A Young Woman with Reduced Factor VII Activity and Low von Willebrand Factor Antigen: A Diagnostic Challenge in Haemostasis
Today’s laboratory case raised an interesting diagnostic question: the coexistence of reduced factor VII activity and low von Willebrand factor (VWF) antigen in a young woman.
The laboratory findings included:
- Factor VII activity: approximately 30–36 percent
- VWF antigen: approximately 40 percent
- Factor VIII activity: within the normal range
- INR: approximately 1.4
Her clinical history included epistaxis and menorrhagia.
This case highlights an important principle in haemostasis: a bleeding phenotype may not always be explained by a single laboratory abnormality.
Reduced factor VII activity may contribute to a prolonged PT/INR, while reduced VWF may be relevant to mucocutaneous bleeding. However, VWF antigen alone is insufficient to establish the diagnosis or subtype of von Willebrand disease. VWF activity, repeat testing, and the full clinical context are essential for interpretation.
A question for colleagues working in haemostasis:
When reduced factor VII activity and low VWF antigen are found in the same patient, which additional tests would you prioritize to establish the clinical significance of each finding?”
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