Portal Vein Thrombosis Associated to Prothrombin G20210A Mutation and Protein C Deficiency

Portal vein thrombosis (PVT) is diagnosed by imaging methods. Once diagnosed by means of ultrasound, Doppler ultrasound can be performed to distinguish between a benign and malignant thrombus. If further information is required, magnetic resonance angiography or contrast-enhanced computed tomography is the next step, and if these tests are unsatisfactory, digital subtraction angiography should be performed. Many papers have been published dealing with alternative methods of treating PVT, but the material is fairly heterogeneous. In symptomatic non-cavernomatous PVT, recanalization using local methods is recommended by many authors. Implantation of transjugular intrahepatic portosystemic shunt is helpful in cirrhotic patients with non-cavernomatous PVT in reducing portal pressure and in diminishing the risk of re-thrombosis. In noncirrhotic patients with recent PVT, some authors recommend anticoagulation alone. In chronic thrombotic occlusion of the portal vein, local measures may be implemented if refractory symptoms of portal hypertension are evident.

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“…3). The complete and spontaneous lysis of PVT associated with different diseases or procedures has been reported in the literature (43).…”

Section: Radiological Interventions Of Portal Vein Thrombosismentioning

confidence: 99%

Imaging and radiological interventions of portal vein thrombosis

et al. 2005

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“…12 Several cases of PVT associated with prothrombin gene mutation alone or with other thrombophilias (homozygous C677T MTHFR mutation and hyperhomocysteinaemia; protein C deficiency) have been reported. [13][14][15] Homozygosity for the C677T MTHFR mutation may lead to mild hyperhomocysteinaemia and thus possibly increase the thrombotic risk. Nevertheless, in this patient homocysteine level was in normal range.…”

Section: Discussionmentioning

confidence: 99%

Portal and Mesenteric Vein Thromboses in a Patient With Prothrombin G20210 Mutation, Elevated Lipoprotein (a), and High Factor VIII

Hirmerová

Liška

Mírka

et al. 2007

Clin Appl Thromb Hemost

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A 65-year-old man was examined for abdominal pain. Portal and mesenteric vein thromboses were described by ultrasound and computed tomography. No local cause was found. The patient had a positive history of venous thromboembolism. Thrombophilia workup revealed prothrombin G20210A mutation (heterozygous), C677T mutation of methylenetetrahydrofolate reductase gene (homozygous), elevated level of lipoprotein (a), and high level of coagulation factor VIII. Anticoagulation was started and planned for a long-term duration. The etiology of portal vein thrombosis is often multifactorial, with various combinations of systemic factors (inherited or acquired prothrombotic conditions) and local precipitating factors (inflammation, injury to the portal venous system, cancer of the abdominal organs, cirrhosis). The reported prevalence of hypercoagulable states in patients with portal vein thrombosis has been very heterogeneous so far. Some authors support a role of the prothrombin G20210A mutation. In the reported patient, this mutation was revealed in a combination with other hypercoagulable states.

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CT features of non-malignant portal vein thrombosis: A pictorial review

Han

et al. 2012

Clinics and Research in Hepatology and Gastroenterology

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Portal Vein Thrombosis Associated to Prothrombin G20210A Mutation and Protein C Deficiency

Cited by 4 publications

References 12 publications

Imaging and radiological interventions of portal vein thrombosis

Imaging and radiological interventions of portal vein thrombosis

Portal and Mesenteric Vein Thromboses in a Patient With Prothrombin G20210 Mutation, Elevated Lipoprotein (a), and High Factor VIII

CT features of non-malignant portal vein thrombosis: A pictorial review

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