Pattern of Vascular Involvement in Egyptian Patients with Budd-Chiari Syndrome: Relation to Etiology and Impact on Clinical Presentation

Sakr, M. S.; Abdelhakam, Sara M.; Dabbous, Hany; Abdelmoaty, Ahmed S.; Ebada, Hend E.; Al-Banna, Wael M.; Ghazy, Mohamed Shaker; Aboelmaaty, Mohamed E.; Eldorry, Ahmed

doi:10.5604/01.3001.0012.0933

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Previous studies found that BCS was usually occurring during the third or fourth decade of life, with slightly more common predominance in females. 10 Another study in Egypt describing disease pattern in Delta region and Cairo found more females affection than males with M/F ratio 43/57 and mean patient age about 28 years, 11 while our study showed that BCS is mainly occurring at middle age with the mean age about 32 years with male predominance: M/F 28/22. AN Algerian study found that M/F was 45/70 and the mean age was 34 years.…”

Section: Discussioncontrasting

confidence: 43%

“…31 This study showed that HVs obstruction was the most common pattern of venous obstruction (80%), combined HVs and IVC obstruction was similar to isolated IVC obstruction and were observed in 10%, while in another Egyptian study by Sakr et al, HVs obstruction, IVC obstruction, and combined HVs and IVC obstruction were found in 43%, 3%, and 21% of patients, respectively. 11 Darwish Murad reported isolated obstruction of HV, IVC, and both veins in 62%, 7%, and 31% of patients, respectively. Behcet's disease was the main etiology associated with IVC obstruction in this study.…”

Section: Dovepressmentioning

confidence: 98%

“…14 Another Egyptian study by Sakr and his colleagues observed that factor V Leiden mutation was present in 23% of patients. 11 Similarly, a study in India by Mohanty et al found that FVLM was the most common etiology of BCS (26% of patients). 18 However, another Egyptian study showed that FVLM was the second most common mutation found in 48.6% of patients (42.9% heterozygous and 5.7% homozygous).…”

mentioning

confidence: 93%

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Epidemiological Characteristics and Etiology of Budd-Chiari Syndrome in Upper Egypt

Hameed¹,

Elbeih²,

El-Aziz³

et al. 2020

JBM

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Section: Discussioncontrasting

confidence: 43%

Section: Dovepressmentioning

confidence: 98%

mentioning

confidence: 93%

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Epidemiological Characteristics and Etiology of Budd-Chiari Syndrome in Upper Egypt

Hameed¹,

Elbeih²,

El-Aziz³

et al. 2020

JBM

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“… 4 – 6 We, however, showed in our patient that the venous obstruction was noted in both the HV and the IVC. Combined HV and IVC obstruction was found in 10% and 21% of BCS patients in studies conducted in Egypt by Ahmed et al 15 and Sakr et al, 16 respectively. Darwish Murad et al 17 in their study of patients treated at tertiary hospitals in France and the Netherlands found that 31% of patients with BCS had combined HV and IVC obstruction.…”

Section: Discussionmentioning

confidence: 92%

A rare case of constrictive pericarditis with Budd–Chiari syndrome due to right atrial thrombosis

Pillay

Moffat

2021

SAGE Open Medical Case Reports

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Patients living with HIV (PLWH) with previous pulmonary tuberculosis, presenting with disproportionate ascites to peripheral congestion, should alert the clinician to consider constrictive pericarditis and Budd–Chiari syndrome (BCS). Constrictive pericarditis is the scarring and loss of the pericardial sac elasticity. The aetiology of constrictive pericarditis varies between developed and developing countries, with infective causes like tuberculosis being significant in South Africa. Budd–Chiari syndrome is a group of disorders characterised by hepatic venous outflow obstruction. The level of obstruction in Budd–Chiari syndrome varies globally. In Asia, South Africa, India, and China, obstruction is predominantly found in the inferior vena cava while in Western countries, hepatic vein obstruction occurs. Patients living with HIV are at increased risk of arterial and venous thromboembolism. The clinician must consider Budd–Chiari syndrome in patients living with HIV presenting with ascites. In patients living with HIV, tuberculosis co-infection has been associated with a higher risk of pericarditis. Both constrictive pericarditis and Budd–Chiari syndrome share a remarkably similar clinical presentation, with ascites and hepatomegaly. There is a dearth of literature on co-existent constrictive pericarditis and Budd–Chiari syndrome. We describe a 31-year-old HIV-infected female, on anti-retroviral therapy (CD4 count 208 cells/uL, undetected viral load), with previous pulmonary tuberculosis, who presented with a 2-month history of abdominal swelling, peripheral oedema, and New York Heart Association grade 4 dyspnoea. Examination revealed an elevated jugular venous pulsation with CV waves, atrial fibrillation, right-sided S3 gallop, pansystolic murmur (3/6) at the left sternal border, tender hepatomegaly, and massive ascites with minimal peripheral oedema. The discordant size of ascites prompted investigations, namely, ultrasound abdomen, echocardiogram, and computed tomography (chest and abdomen). These revealed constrictive pericarditis and Budd–Chiari syndrome with thrombus formation in the right atrium, hepatic vein, and inferior vena cava. She was initiated onto anti-coagulation, anti-tuberculosis therapy and referred for pericardiectomy. Clinicians must maintain a suspicion for constrictive pericarditis and Budd–Chiari syndrome in HIV-infected patients, especially in those with a previous tuberculosis, presenting with features of right heart failure.

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Budd–Chiari Syndrome: East versus West

Chaubal

Shukla

2019

Budd-Chiari Syndrome

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Pattern of Vascular Involvement in Egyptian Patients with Budd-Chiari Syndrome: Relation to Etiology and Impact on Clinical Presentation

Abstract: Isolated HVs occlusion was the most common pattern of vascular involvement in Egyptian patients with primary BCS. Vascular pattern of involvement affected the clinical presentation and was related to the underlying thrombophilia in those patients.

Cited by 4 publications

References 19 publications

Epidemiological Characteristics and Etiology of Budd-Chiari Syndrome in Upper Egypt

Epidemiological Characteristics and Etiology of Budd-Chiari Syndrome in Upper Egypt

A rare case of constrictive pericarditis with Budd–Chiari syndrome due to right atrial thrombosis

Budd–Chiari Syndrome: East versus West

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