[Mesenteric vein thrombosis and protein C and S deficiency in a patient with chronic hepatitis C on treatment with interferon and ribavirin].
We describe the case of a 67 year old male with chronic hepatitis C on treatment with pegylated interferon and ribavirin who, after two and a half months of combined treatment, presented with a picture of acute mesenteric vein thrombosis that required urgent surgery. It re-occurred several days later and was his cause of death. In the thrombophilia study carried out immediately after surgery a decrease in protein C and S was considered as a cause of hypercoagulability. Protein C and S deficiency, natural anticoagulants synthesised in the liver, in patients without hepatic disease is a known cause of mesenteric thrombosis. Its decrease has also been described in the context of chronic hepatic diseases, including C virus chronic hepatitis, although it is not known for sure if this hypercoagulability state is a primary or secondary manifestation. Chronic hepatitis C and treatment with interferon has often been associated with a procoagulant state, and on many occasions due to different factors and mechanisms.
Monterrubio Villar
Jesús
J
Unidad de Cuidados Intensivos, Hospital Don Benito-Villanueva, D. 06400 Don Benito, Badajoz, Spain. suso1@tiscali.es
Córdoba López
Alberto
A
D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D016905:Gram-Negative Bacterial Infections / Q000209:etiology; D006465:Hemoperitoneum / Q000209:etiology; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000209:etiology* / Q000601:surgery; D008642:Mesenteric Veins; D018410:Pneumonia, Bacterial / Q000209:etiology; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D020151:Protein C Deficiency / Q000209:etiology*; D018455:Protein S Deficiency / Q000209:etiology*; D012008:Recurrence; D012121:Respiration, Artificial / Q000009:adverse effects; D012254:Ribavirin / Q000627:therapeutic use*; D020615:Stenotrophomonas maltophilia; D017131:Thrombectomy; D019851:Thrombophilia / Q000209:etiology*; D020246:Venous Thrombosis / Q000209:etiology* / Q000601:surgery
D000998:Antiviral Agents; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D012254:Ribavirin