title: Portal vein thrombosis associated with psoriasis: a case report.
abstract: BACKGROUND
  Psoriasis is no longer viewed as an isolated dermatological ailment and instead is considered a systemic disease. The extension of this spectrum has heightened the known risk of morbidity and mortality due to the involvement of cardiovascular system and the risk of venous thrombosis. A number of cases have reported the increased occurrence of deep vein thrombosis and pulmonary embolism in the background of psoriasis, however portal vein thrombosis has not been reported to date. We report an index case of chronic portal vein thrombosis in a diagnosed patient with psoriasis.
  
  
  METHODS
  A 67-year-old South-Asian female previously diagnosed and treated for psoriasis presented with a four month history of abdominal pain associated with abdominal distension. Clinical examination revealed an enlarged spleen and free fluid in the abdomen. Imaging with ultrasonography and computed tomography of the abdomen revealed features compatible with chronic portal vein thrombosis with cavernous transformation.
  
  
  CONCLUSIONS
  This case highlights the importance of having clinical awareness of occurrence of thrombosis in patients with psoriasis. Typical symptoms favoring thrombosis should prompt thorough investigation to exclude this rare yet possible complication in patients with psoriasis, including that of portal vein thrombosis. Prophylaxis with anticoagulation still lacks strength of evidence to be justified in psoriasis. The exact pathogenesis of venous thromboembolism in psoriasis is still unexplained and further studies are needed to clarify the causal association.
authors.affiliation: Department of Medicine, National Hospital of Sri Lanka, Regent Street, Colombo, Sri Lanka. yudhishdran@yahoo.com.
authors.forename: Jevon M
authors.initials: JM
authors.lastname: Yudhishdran
authors.affiliation: Department of Medicine, National Hospital of Sri Lanka, Regent Street, Colombo, Sri Lanka. rayno.navinan@gmail.com.
authors.forename: Rayno
authors.initials: R
authors.lastname: Navinan
authors.affiliation: Department of Medicine, Colombo South Teaching Hospital, Colombo, Sri Lanka. jlakshmykns@yahoo.com.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Jeyalakshmy
authors.affiliation: Department of Medicine, National Hospital of Sri Lanka, Regent Street, Colombo, Sri Lanka. ashoka.ratnatilaka@gmail.com.
authors.forename: Ashoka
authors.initials: A
authors.lastname: Ratnatilaka
mesh_terms: D000368:Aged; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D011565:Psoriasis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology