Study of portal vein thrombosis in patients with idiopathic portal hypertension in Japan.
OBJECTIVE
The aim of this study was to elucidate the incidence and clinical manifestations of portal vein thrombosis (PVT) in patients with idiopathic portal hypertension (IPH) in Japan during long-term follow-up.


METHODS
Twenty-two patients with IPH were examined for PVT by sonography during a follow-up of 12+/-6 years. Clinical manifestations and patient outcome related to PVT were studied. Seventy patients with liver cirrhosis were examined by sonography as an incidence control of thrombosis.


RESULTS
Nine IPH patients had portal thrombosis (9/22, 41%), a higher incidence than in liver cirrhosis patients (7/70, 10%). Those with thrombosis showed ascites, marked hypersplenism, and low serum albumin. Four patients with thrombosis died. Patients without thrombosis showed less clinical problems after long-term follow-up. Plasma antithrombin III and protein C activity decreased in almost half of the patients. However, there were no differences in these parameters between patients with and without thrombosis.


CONCLUSIONS
In Japan, IPH patients had a high incidence of portal thrombosis, a significant factor for poor prognosis. Whether the management of PVT contributes to an improvement of a clinical course of IPH or not should be clarified in further study.
Matsutani
Shoichi
S
Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan. matsutani@faculty.chiba-u.jp
Maruyama
Hitoshi
H
Akiike
Taro
T
Kobayashi
Satoshi
S
Yoshizumi
Hiroaki
H
Okugawa
Hidehiro
H
Fukuzawa
Takeshi
T
Kimura
Kunio
K
Saisho
Hiromitsu
H
D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D001777:Blood Coagulation; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011486:Protein C / Q000032:analysis; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*
D011486:Protein C; D000990:Antithrombin III