Acute partial Budd-Chiari syndrome and portal vein thrombosis in cytomegalovirus primary infection: a case report.
BACKGROUND
Splanchnic vein thrombosis may complicate inherited thrombotic disorders. Acute cytomegalovirus infection is a rare cause of acquired venous thrombosis in the portal or mesenteric territory, but has never been described extending into a main hepatic vein.


METHODS
A 36-year-old immunocompetent woman presented with acute primary cytomegalovirus infection in association with extensive thrombosis in the portal and splenic vein. In addition, a fresh thrombus was evident in the right hepatic vein. A thorough evaluation for a hypercoagulable state was negative. The clinical course, biological evolution, radiological and histological findings were consistent with cytomegalovirus hepatitis complicated by a partial acute Budd-Chiari syndrome and portal thrombosis. Therapeutic anticoagulation was associated with a slow clinical improvement and partial vascular recanalization.


CONCLUSIONS
We described in details a new association between cytomegalovirus infection and acute venous thrombosis both in the portal vein and in the right hepatic vein, realizing a partial Budd-Chiari syndrome. One should be aware that this rare thrombotic event may be complicated by partial venous outflow block.
Spahr
Laurent
L
Gastroenterology and Hepatology, Ospedale Regionale, Lugano, Switzerland. Laurent.Spahr@hcuge.ch
Cerny
Andreas
A
Morard
Isabelle
I
Rubbia-Brandt
Laura
L
Schrenzel
Jacques
J
D000208:Acute Disease; D000328:Adult; D006502:Budd-Chiari Syndrome / Q000209:etiology*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D011169:Portal Vein; D020246:Venous Thrombosis / Q000209:etiology*