There are only 2 prior reported cases of acquired factor VII deficiency associated with AML described in the literature.2,3 To the best of our knowledge, this case is the third reported case of AML with acquired factor VII deficiency and the second reported case of AML with an associated acquired trisomy 8 cytogenetic abnormality. The gene discussed is F7; the disease is hyperinsulinemic hypoglycemia, familial, 4.