Role in Disease
Inborn deficiency of factor X is very rare (1:500,000), and may present with epistaxis (nosebleeds), hemarthrosis (bleeding into joints) and gastrointestinal blood loss. Apart from congenital deficiency, low factor X levels may occur occasionally in a number of disease states. For example, factor X deficiency may be seen in amyloidosis, where factor X is adsorbed to the amyloid fibrils in the vasculature.
Deficiency of vitamin K or antagonism by warfarin (or similar medication) leads to the production of an inactive factor X. In warfarin therapy, this is desirable to prevent thrombosis. As of late 2007, four out of five emerging anti-coagulation therapeutics targeted this enzyme.
Inhibiting Factor Xa would offer an alternate method for anticoagulation. Direct Xa inhibitors are popular anticoagulants.
| Condition | Prothrombin time | Partial thromboplastin time | Bleeding time | Platelet count |
|---|---|---|---|---|
| Vitamin K deficiency or warfarin | Prolonged | Normal or mildly prolonged | Unaffected | Unaffected |
| Disseminated intravascular coagulation | Prolonged | Prolonged | Prolonged | Decreased |
| Von Willebrand disease | Unaffected | Prolonged | Prolonged | Decreased and/or Rejected |
| Hemophilia | Unaffected | Prolonged | Unaffected | Unaffected |
| Aspirin | Unaffected | Unaffected | Prolonged | Unaffected |
| Thrombocytopenia | Unaffected | Unaffected | Prolonged | Decreased |
| Liver failure, early | Prolonged | Unaffected | Unaffected | Unaffected |
| Liver failure, end-stage | Prolonged | Prolonged | Prolonged | Decreased |
| Uremia | Unaffected | Unaffected | Prolonged | Unaffected |
| Congenital afibrinogenemia | Prolonged | Prolonged | Prolonged | Unaffected |
| Factor V deficiency | Prolonged | Prolonged | Unaffected | Unaffected |
| Factor X deficiency as seen in amyloid purpura | Prolonged | Prolonged | Unaffected | Unaffected |
| Glanzmann's thrombasthenia | Unaffected | Unaffected | Prolonged | Unaffected |
| Bernard-Soulier syndrome | Unaffected | Unaffected | Prolonged | Decreased or unaffected |
| Factor XII deficiency | Unaffected | Prolonged | Unaffected | Unaffected |
Read more about this topic: Factor X
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