High prevalence of thrombophilic genotypes in patients with acute mesenteric vein thrombosis.
OBJECTIVE
Mesenteric vein thrombosis is a rare but severe abdominal emergency, often requiring intestinal resection. New genetic prothrombotic defects such as factor V Leiden, the prothrombin transition G20210A, and the methylenetetrahydrofolate reductase TT677 genotype have been described in association with venous thrombosis. Our goal was to assess prevalence and clinical significance of genetic thrombophilia in mesenteric vein thrombosis.


METHODS
Twelve patients with acute mesenteric vein thrombosis were compared with 431 healthy people from the same geographical area. The factor V Leiden, the prothrombin transition G20210A, and the methylenetetrahydrofolate reductase TT677 genotype were identified by polymerase chain reaction and restriction analysis.


RESULTS
A thrombophilic genotype was present in 9 patients (75%): the methylenetetrahydrofolate reductase TT677 genotype was present in 6 (50%), the factor V Leiden in 3 (25%), and the prothrombin transition G20210A in 3 (25%). Combined mutations were present in 4 (33%) patients.


CONCLUSIONS
The factor V Leiden, the prothrombin transition G20210A, and the methylenetetrahydrofolate reductase TT677 genotype are important predisposing factors in the pathogenesis of mesenteric vein thrombosis. Their identification bears strong clinical implications for management of patients with mesenteric vein thrombosis.
Amitrano
L
L
Gastroenterology Unit, A. Cardarelli Hospital, Naples, Italy.
Brancaccio
V
V
Guardascione
M A
MA
Margaglione
M
M
Iannaccone
L
L
Dandrea
G
G
Ames
P R
PR
Marmo
R
R
Mosca
S
S
Balzano
A
A
D000208:Acute Disease; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D008642:Mesenteric Veins; D016017:Odds Ratio; D016133:Polymerase Chain Reaction; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D019851:Thrombophilia / Q000235:genetics*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*