title: Portal and mesenteric vein thromboses in a patient with prothrombin G20210 mutation, elevated lipoprotein (a), and high factor VIII.
abstract: A 65-year-old man was examined for abdominal pain. Portal and mesenteric vein thromboses were described by ultrasound and computed tomography. No local cause was found. The patient had a positive history of venous thromboembolism. Thrombophilia workup revealed prothrombin G20210A mutation (heterozygous), C677T mutation of methylenetetrahydrofolate reductase gene (homozygous), elevated level of lipoprotein (a), and high level of coagulation factor VIII. Anticoagulation was started and planned for a long-term duration. The etiology of portal vein thrombosis is often multifactorial, with various combinations of systemic factors (inherited or acquired prothrombotic conditions) and local precipitating factors (inflammation, injury to the portal venous system, cancer of the abdominal organs, cirrhosis). The reported prevalence of hypercoagulable states in patients with portal vein thrombosis has been very heterogeneous so far. Some authors support a role of the prothrombin G20210A mutation. In the reported patient, this mutation was revealed in a combination with other hypercoagulable states.
authors.affiliation: 2nd Department of Internal Medicine, University Hospital, Charles University, Pilsen-Bory, Dr. E. Benese 13, Pilsen, Czech Republic. hirmerova@fnplzen.cz
authors.forename: Jana
authors.initials: J
authors.lastname: Hirmerova
authors.forename: Hirmerova
authors.initials: H
authors.lastname: Jana
authors.forename: Vaclav
authors.initials: V
authors.lastname: Liska
authors.forename: Liska
authors.initials: L
authors.lastname: Vaclav
authors.forename: Hynek
authors.initials: H
authors.lastname: Mirka
authors.forename: Mirka
authors.initials: M
authors.lastname: Hynek
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Chudacek
authors.forename: Chudacek
authors.initials: C
authors.lastname: Zdenek
authors.forename: Vladislav
authors.initials: V
authors.lastname: Treska
authors.forename: Treska
authors.initials: T
authors.lastname: Vladislav
mesh_terms: D000368:Aged; D005169:Factor VIII / Q000032:analysis*; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D008642:Mesenteric Veins; D009154:Mutation; D011169:Portal Vein; D011516:Prothrombin / Q000235:genetics*; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D017270:Lipoprotein(a); D011516:Prothrombin; D005169:Factor VIII