It is important to emphasize that in patients with plasma cell disorders, bleeding tendency may be enhanced compared to acquired isolated factor VII deficiency from other underlying conditions and due to inherited defects due to a number of concomitant factors: thrombocytopenia and platelet dysfunction (secondary to bone marrow insufficiency and/or chemotherapy), hyperfibrinolysis, hyperviscosity, vascular fragility, impaired vasoconstriction, renal failure, and thromboprophylaxis [19]. The gene discussed is F7; the disease is hyperinsulinemic hypoglycemia, familial, 4.