Thrombophilic conditions in non-cirrhotic portal vein thrombosis.
OBJECTIVE
To study the prevalence of thrombophilic conditions in patients with acute and chronic portal vein thrombosis (PVT) and to compare it with those in patients suffering from deep vein thrombosis (DVT) after lower limb arthroplasty and in healthy subjects.


METHODS
Twenty-six patients with spontaneous PVT (20 chronic, 6 acute) with normal liver function and not receiving anticoagulants were evaluated for thrombophilic conditions. Levels of protein C, protein S and antithrombin were compared with those in 50 healthy controls. Factor V gene 'Leiden' mutation (FVL) and high homocysteine levels were looked for in patients with PVT and in 18 patients developing post-arthroplasty lower limb DVT despite anticoagulation.


RESULTS
Of 26 patients with PVT, 19 had at least one thrombotic condition (acute PVT 5/6, chronic PVT 14/20) and 12 had more than one such condition; in comparison, of 18 patients with DVT, eight had one thrombophilic condition and one had two such conditions (p=0.03). Patients with PVT had significantly lower levels of protein C, protein S and antithrombin than healthy subjects and those with DVT. Six patients had Factor VIII levels above 150%; four had elevated homocysteine levels and three had detectable anti-cardiolipin antibodies. Three patients with PVT (acute 2, chronic 1) were heterozygous for FVL mutation.


CONCLUSIONS
Underlying thrombophilic conditions are common in Indian patients with spontaneous PVT. In many patients, multiple thrombophilic conditions are present and these may play a role in the pathogenesis of PVT.
Shah
Sudeep R
SR
Division of Gastrointestinal Surgery, P D Hinduja National Hospital and Medical Research Center, Mumbai. shahsudeep@hotmail.com
DasGupta
A
A
Sharma
A
A
Joshi
Anand
A
Desai
Devendra
D
Abraham
Philip
P
Rathi
Pravin
P
Bapat
Mukta
M
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology*; D011446:Prospective Studies; D019851:Thrombophilia / Q000150:complications* / Q000503:physiopathology; D020246:Venous Thrombosis / Q000209:etiology*