title: [Oral contraceptives and blood diseases are the most common causes of Budd-Chiari syndrome].
abstract: Two cases of young patients with the chronic form of Budd-Chiari syndrome are reported. The first concerns a 22-year-old woman with a 6-month history of hepatomegaly, who had used oral contraceptives almost continuously during the five years preceding diagnosis. In a thorough diagnostic work-up, thromboses were detected in all but one of the hepatic veins, and a possible non-occluding thrombosis in the retrohepatic portion of the inferior vena cava. In the blood and bone marrow, findings were compatible with polycythaemia rubra vera, and a high anti-cardiolipin antibody titre was found. The second case concerns a 25-year-old male smoker with normal bone marrow, who had thromboses in at least two of the hepatic veins, though the inferior vena cava was not occluded. In both cases a mesocaval shunt was interposed with synthetic grafts, and postoperatively the patients are doing well--at sixteen and five months, respectively. Both are maintained on anticoagulants, and even without diuretics there has been no recurrence of ascites. The woman takes a small dose of hydroxy-urea to control her hypercoagulability. To our knowledge, hers is the first case to be reported of Budd-Chiari syndrome with hypercoagulability due to the concomitant presence of oral contraceptives, polycythaemia rubra vera and anti-phospholipid antibodies.
authors.forename: S
authors.initials: S
authors.lastname: Almer
authors.forename: G
authors.initials: G
authors.lastname: Bodemar
authors.forename: B O
authors.initials: BO
authors.lastname: Rydén
authors.forename: J
authors.initials: J
authors.lastname: Elfström
authors.forename: L
authors.initials: L
authors.lastname: Franzén
authors.forename: I
authors.initials: I
authors.lastname: Ihse
authors.forename: M
authors.initials: M
authors.lastname: Resjö
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001166:Arteriovenous Shunt, Surgical; D006502:Budd-Chiari Syndrome / Q000209:etiology* / Q000601:surgery; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000009:adverse effects; D005260:Female; D006801:Humans; D016912:Levonorgestrel; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009644:Norgestrel / Q000009:adverse effects; D011087:Polycythemia Vera / Q000150:complications*; D011859:Radiography
chemical_list: D000925:Anticoagulants; D003277:Contraceptives, Oral, Combined; D009644:Norgestrel; D004997:Ethinyl Estradiol; D016912:Levonorgestrel
vernacular_title: P-piller och blodsjukdomar vanligaste orsakerna till Budd-Chiaris syndrom.