Which coagulation factor is commonly elevated in liver disease?

Which coagulation factor is commonly elevated in liver disease?

• A. II
• B. VII
• C. VIII
• D. X

Answer: (C)

Factors II, VII, and X are all produced by the liver and typically decrease when liver function is impaired, leading to longer clotting times. The one that tends to rise in liver disease is factor VIII. This is because factor VIII is made mainly by endothelial cells (not the liver) and behaves as an acute‑phase reactant, so its level often increases during inflammation. Additionally, von Willebrand factor, which stabilizes and carries factor VIII in the circulation, is also increased in liver disease, further boosting VIII levels. So, despite the liver’s overall decreased production of most coagulation factors, factor VIII commonly ends up elevated, contrasting with the others listed which tend to fall.

Factors II, VII, and X are all produced by the liver and typically decrease when liver function is impaired, leading to longer clotting times. The one that tends to rise in liver disease is factor VIII. This is because factor VIII is made mainly by endothelial cells (not the liver) and behaves as an acute‑phase reactant, so its level often increases during inflammation. Additionally, von Willebrand factor, which stabilizes and carries factor VIII in the circulation, is also increased in liver disease, further boosting VIII levels. So, despite the liver’s overall decreased production of most coagulation factors, factor VIII commonly ends up elevated, contrasting with the others listed which tend to fall.