Factor V - Sodium Citrate

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No Fasting Required

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Coagulation factor activity measurement.

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Factor V - Sodium Citrate Test Information Guide

Why is it done?
- Measures Factor V activity levels in the blood, a critical protein in the coagulation cascade responsible for blood clotting
- Evaluates for bleeding disorders and excessive clotting tendencies, particularly Factor V deficiency
- Ordered when patients present with unexplained bleeding, bruising, prolonged bleeding after surgery or dental procedures, or recurrent miscarriages
- Used as part of comprehensive coagulation screening (prothrombin time or PT panel) to diagnose inherited or acquired coagulation disorders
- Monitors patients on anticoagulant therapy or those with liver disease, disseminated intravascular coagulation (DIC), or vitamin K deficiency
- Performed during pre-operative assessment to assess hemostatic risk before elective surgeries
Normal Range
- Normal Factor V activity: 70% - 130% (or 0.70 - 1.30 in International Units)
- Results are typically expressed as a percentage of normal activity or as a ratio (International Units)
- Low values (below 70%): Indicate Factor V deficiency or decreased clotting ability, associated with increased bleeding risk
- High values (above 130%): May indicate thrombophilia or increased clotting tendency, though interpretation depends on clinical context
- Normal results suggest adequate Factor V levels and normal clotting function for that component of the coagulation cascade
- Reference ranges may vary between laboratories; always consult the specific laboratory report for exact values
Interpretation
- Results between 70-130%: Normal Factor V activity indicates adequate participation in the common pathway of the coagulation cascade
- Results 50-70%: Mild Factor V deficiency; patient may have minimal symptoms or bleeding tendency during trauma or surgery
- Results 25-50%: Moderate deficiency; significant bleeding risk including spontaneous minor bleeding, epistaxis, and bleeding after procedures
- Results below 25%: Severe Factor V deficiency; high risk for severe spontaneous bleeding including intracranial, GI, or joint hemorrhage
- Low results may indicate: Inherited Factor V deficiency, liver disease (impaired synthesis), DIC, vitamin K deficiency, prolonged anticoagulant therapy, or acquired Factor V inhibitors
- Elevated results may suggest: Thrombophilia, Factor V Leiden mutation (requires additional testing), acute phase reaction, or inflammation
- Results must be interpreted with clinical presentation, family history, other coagulation studies (PT, aPTT, platelet count), and patient medications
- Serial measurements may be needed to distinguish between acute conditions and chronic disorders
Associated Organs
- Primary organ system: Hematologic (blood) and hepatic (liver) systems
- Liver: Synthesizes Factor V; severe hepatic disease impairs Factor V production and increases bleeding risk
- Bone marrow: Site of production of platelets and other blood cells involved in hemostasis
- Condition associations - Factor V deficiency (inherited or acquired), hemophilia variants, Factor V Leiden thrombophilia, disseminated intravascular coagulation, liver cirrhosis, hepatitis, and acute liver failure
- Complications of abnormal results: Uncontrolled bleeding (intracranial hemorrhage, GI bleeding, hemarthrosis), thromboembolic events (deep vein thrombosis, pulmonary embolism, stroke), and recurrent pregnancy loss
- Related vascular complications: Increased surgical bleeding risk, higher rate of transfusion requirements, and compromised wound healing
- Affects cardiovascular system through thrombotic events in patients with elevated Factor V levels or Factor V Leiden mutation
Follow-up Tests
- Prothrombin Time (PT/INR): Often abnormal when Factor V is deficient; may require repeat testing to confirm diagnosis
- Activated Partial Thromboplastin Time (aPTT): May be prolonged with Factor V deficiency; used for comprehensive coagulation assessment
- Factor V Leiden testing: Genetic test recommended if elevated Factor V or thrombophilia is suspected, especially in families with VTE history
- Thrombin Time (TT): Assesses overall thrombin generation and may be abnormal in factor deficiencies
- Platelet count: Essential to rule out thrombocytopenia as contributor to bleeding disorder
- Mixing study (1:1 mix of patient plasma with normal plasma): If Factor V is low, mixing study corrects abnormality; if inhibitor present, it may not correct
- Liver function tests: Ordered if liver disease suspected as cause of low Factor V levels
- Prothrombin gene mutation testing: If inherited deficiency suspected
- D-dimer and fibrinogen: To assess for DIC if multiple factor deficiencies present
- Monitoring frequency: Repeat Factor V testing typically every 3-6 months for chronic conditions or annually for stable inherited deficiency; more frequent testing if on new anticoagulation therapy or after interventions
Fasting Required?
- Fasting: No - Fasting is not required for Factor V testing
- Test can be performed at any time of day without dietary restrictions
- Patient preparation: Maintain normal hydration; avoid excessive caffeine intake immediately before testing
- Medications to avoid: Do not stop or alter anticoagulant medications (warfarin, direct oral anticoagulants) before testing unless specifically instructed by physician
- Inform phlebotomist of all medications, including aspirin, NSAIDs, herbal supplements (ginkgo, ginseng), and over-the-counter blood thinners
- Special instructions: Avoid alcohol consumption for 24 hours before testing if possible, as it may affect coagulation
- Blood collection: Performed via venipuncture into sodium citrate tube (3.2% citrate); collection tube must be filled to appropriate level as underfilled tubes affect results
- Timing: Results typically available within 24-48 hours; urgent cases may be processed same day
- Note: Specimen must be transported to lab immediately and kept at room temperature; improper handling may compromise results

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