title: Portal vein thrombosis associated with protein C deficiency and elevated Factor VIII in hepatosplenic schistosomiasis.
abstract: Portal vein thrombosis is considered a vaso-occlusive process that can appear during the course of hepatosplenic Schistosoma mansoni, but may result from impaired portal blood flow or be associated with acquired or inherited thrombophilic factors. Here, we report the case of a 67-year-old woman who developed thrombocytopenia as a result of hypersplenism. Following the diagnosis of hepatosplenic schistosomiasis, portal vein thrombosis was detected by ultrasound examination, while haematological tests revealed low levels of protein C (43.3%) and high levels of factor VIII (183.1%). The pathogenesis of portal vein thrombosis remains unclear in some patients with S. mansoni. We recommend, therefore, that early clinical and haemostatic investigations are done to evaluate risk of portal vein thrombosis and hence avoid further complications.
authors.affiliation: aDepartamento de Biofísica e Radiobiologia, Centro de Ciências Biológicas bDepartamento de Medicina Clínica cDepartamento de Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Pernambuco dServiço de Cardiologia, Universidade de Pernambuco, Pernambuco, Brazil eDivision of Medicine, UCL Medical School, Royal Free Campus, London, UK fDepartamento de Bioquímica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco, Pernambuco, Brazil.
authors.forename: Luiz Arthur Calheiros
authors.initials: LA
authors.lastname: Leite
authors.forename: Rita de Cássia dos Santos
authors.initials: Rde C
authors.lastname: Ferreira
authors.forename: Betânia Lucena Domingues
authors.initials: BL
authors.lastname: Hatzlhofer
authors.forename: Maria Conceição Barros
authors.initials: MC
authors.lastname: Correia
authors.forename: Ângela Pontes
authors.initials: ÂP
authors.lastname: Bandeira
authors.forename: James Stuart
authors.initials: JS
authors.lastname: Owen
authors.forename: Vera Lúcia de Menezes
authors.initials: VL
authors.lastname: Lima
authors.forename: Ana Lúcia Coutinho
authors.initials: AL
authors.lastname: Domingues
authors.forename: Edmundo Pessoa
authors.initials: EP
authors.lastname: Lopes
mesh_terms: D000368:Aged; D000818:Animals; D005169:Factor VIII / Q000378:metabolism; D005260:Female; D015870:Gene Expression; D006487:Hemostasis; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000469:parasitology / Q000473:pathology; D011169:Portal Vein / Q000378:metabolism / Q000469:parasitology / Q000473:pathology; D011486:Protein C / Q000378:metabolism; D020151:Protein C Deficiency / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology; D012550:Schistosoma mansoni / Q000472:pathogenicity / Q000502:physiology; D012552:Schistosomiasis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology; D013154:Spleen / Q000378:metabolism / Q000469:parasitology / Q000473:pathology; D013163:Splenomegaly / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology; D013921:Thrombocytopenia / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology; D020246:Venous Thrombosis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000469:parasitology
chemical_list: D011486:Protein C; D005169:Factor VIII