COMBINED deficiencies of prothrombin, plasma thromboplastin component (PTC), Stuart factor (10), and stable factor (7) are found in a number of acquired defects of the clotting mechanism. Parenchymal liver disease, malabsorption syndromes, and hemorrhagic disease of the newborn are typical examples. A similar deficiency is also found during treatment with the coumarins. In this instance, however, the fall in activity of the 4 factors is not simultaneous. Stable factor and Stuart factor are affected first, followed quickly by prothrombin, and somewhat later by PTC.
Thus, for example, in the course of treatment with bishydroxycoumarin (Dicumarol), variable laboratory findings are observed because of varying degrees of depression of the coagulation factors involved. During the stage of recovery from bishydroxycoumarin administration under the influence of the administration of vitamin K1; further dissociation may be observed in the behavior of the clotting agents affected by the anticoagulant. Johnson et al. have shown that
Karaca M, Stefanini M. An Unusual Acquired Coagulation Defect. JAMA. 1962;179(2):165–168. doi:10.1001/jama.1962.03050020000013b
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