Table 24.1 The coagulation factors.

Factor number I II III V VII VIII IX X XI XII XIII Descriptive name Fibrinogen Prothrombin Tissue factor Labile factor Proconvertin Antihaemophilic factor Christmas factor StuartPrower factor Plasma thromboplastin antecedent Hageman (contact) factor Fibrin-stabilizing factor Prekallikrein (Fletcher factor) HMWK (Fitzgerald factor) Active form Fibrin subunit Serine protease Receptor/cofactor* Cofactor Serine protease Cofactor Serine protease Serine protease Serine protease Serine protease Transglutaminase Serine protease Cofactor*

HMWK, high molecular weight kininogen. * Active without proteolytic modification.

Table 24.2 The coagulation factors.

Factor II VII IX X I V VIII XI XIII Plasma half-life (h) 65 5 25 40 90 15 10 45 200 Plasma concentration (mg/L) 100 0.5 5 10 3000 10 0.1 5 30

Comments Prothrombin group: vitamin K needed for synthesis; require Ca2+ for activation

Thrombin interacts with them; increase in inflammation, pregnancy, oral contraceptives

Table 24.3 Screening tests used in the diagnosis of coagulation disorders.

Abnormalities indicated by prolongation Deficiency or abnormality of fibrinogen or inhibition of thrombin by heparin or FDPs Deficiency or inhibition of one or more of the following coagulation factors: VII, X, V, II, fibrinogen Deficiency or inhibition of one or more of the following coagulation factors: XII, XI, IX (Christmas disease), VIII (haemophilia), X, V, II, fibrinogen Fibrinogen deficiency Most common cause of coagulation disorder DIC Heparin therapy Liver disease Warfarin therapy DIC Haemophilia, Christmas disease (+ conditions above)

Screening tests Thrombin time (TT) Prothrombin time (PT) Activated partial thromboplastin time (APTT or PTTK) Fibrinogen quantitation

DIC, liver disease

DIC, disseminated intravascular coagulation; FDPs, fibrin degradation products. NB. Platelet count and the tests of platelet function are also used in screening patients with a bleeding disorder (p. 328).