yemenjmedYemen Journal of MedicinecoVolume 5 Issue 2MultidisciplinaryEnglishMay-August 2026NNY20260625ArticleIsolated Severe Prolongation of Prothrombin Time Revealing Congenital Factor VII Deficiency With Mild Bleeding Phenotype: A Case ReportEnglishY00MohammedAlkhanafsa1EnglishNOsaydMosleh1EnglishYJamilWafi1EnglishYMohammedAlkahtib1EnglishY10.63475/yjm.v5i2.0395Congenital Factor VII (FVII) deficiency is a rare inherited bleeding disorder characterized by marked variability in bleeding severity and poor correlation between factor activity levels and clinical phenotype. We report a 21-year-old woman who presented with recurrent spontaneous ecchymoses without mucosal bleeding, menorrhagia, hemarthrosis, or prior excessive surgical bleeding. Laboratory evaluation demonstrated markedly prolonged prothrombin time (PT) of 96 seconds with an international normalized ratio (INR) of 8.0 and normal activated partial thromboplastin time (aPTT). Repeat testing confirmed persistent isolated PT prolongation. There was no evidence of liver disease, vitamin K deficiency, anticoagulant exposure, disseminated intravascular coagulation, systemic illness, or malignancy. A PT mixing study completely corrected the abnormal PT, supporting a factor deficiency rather than an inhibitor. Specific factor assays demonstrated isolated severe FVII deficiency with activityEnglishFactor VII deficiency, isolated prolonged prothrombin time, INR, coagulation disorder, mild bleeding phenotype, case reporthttps://www.yemenjmed.com/admin/abstract?id=409References1619