[Left branch portal vein thrombosis associated with hyperhomocysteinemia].
A 34 year-old man, who was a smoker, was hospitalised because of severe epigastric and right upper quadrant pain. An isolated left branch portal vein thrombosis was diagnosed using ultrasonography and arteriography. Two thrombogenic pathologies were found: i) a latent myeloproliferative syndrome with spontaneous presence of erythroid colony forming unit (CFU-E) in bone marrow culture, normal blood cell count, platelet count and medullogram; ii) a hyperhomocysteinemia associated with low serum folate levels and a methyl tetrahydrofolate reductase mutation. The association of these two factors probably resulted in portal vein thrombosis. This is the first adult case of a portal vein thrombosis associated with hyperhomocysteinemia. Increased homocysteine serum levels could be a previously unrecognized factor for portal vein thrombosis. Homocysteinemia should be systematically investigated in patients with idiopathic portal vein thrombosis since folate supplements could prevent deleterious vascular effects of hyperhomocysteinemia.
Audemar
F
F
Service de Médecine A, Hôpitaux Civils, Colmar.
Denis
B
B
Blaison
G
G
Mazurier
I
I
Peter
A
A
Serbout
R
R
D000328:Adult; D005492:Folic Acid / Q000627:therapeutic use; D005494:Folic Acid Deficiency / Q000150:complications; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D009154:Mutation; D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics; D011169:Portal Vein; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000209:etiology
D005492:Folic Acid; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)