Chronic Budd-Chiari syndrome as a rare complication of Crohn's disease: a case report.
The Budd-Chiari syndrome (BCS) is characterized by hepatic venous outflow obstruction involving the hepatic veins, inferior vena cava, or both. BCS has occasionally been reported in the literature as a very rare complication of ulcerative colitis. However, association of Crohn's disease (CD) and BCS is extremely rare with only a single case reported in the world literature to date. We report a case of a young woman with chronically active, therapy-resistant CD who developed massive ascites, elevation of liver enzymes, and coagulopathy in the course of her disease. She was subsequently diagnosed with BCS for which a successful liver transplantation was performed. Chronically active therapy resistant CD and methylenetetrahydrofolate reductase gene mutation have been identified as possible risk factors for development of BCS in this patient.
Brinar
Marko
M
Division of Gastroenterology, University Hospital Zagreb - Rebro, Kispaticeva 12, Zagreb 10000, Croatia. marko.brinar@zg.htnet.hr
Hrstic
Irena
I
Cukovic-Cavka
Silvija
S
Padovan
Ranka Stern
RS
Zupancic-Salek
Silva
S
Vucelic
Boris
B
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001201:Ascites / Q000000981:diagnostic imaging / Q000473:pathology; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D016031:Liver Transplantation; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation; D010690:Phlebography; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D014859:Warfarin / Q000627:therapeutic use; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D014859:Warfarin; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D016559:Tacrolimus