Top

Published in:

01-10-2009 | Case Report

Portal vein thrombosis in a patient with hepatitis C virus-related cirrhosis complicated with antiphospholipid syndrome

Authors: Yohei Kida, Etsuko Maeshima, Yoichi Yamada

Published in: Rheumatology International | Issue 12/2009

Abstract

We report a rare case of portal vein thrombosis (PVT) associated with antiphospholipid syndrome (APS) and hepatitis C virus-related cirrhosis. A 59-year-old woman with hepatitis C virus (HCV) infection was admitted because of coma. The blood test showed a typically cirrhosis pattern including an elevated serum ammonia level. Abdominal computed tomography showed liver cirrhosis and thrombus in the right branch of the portal vein. To elucidate the cause of PVT, antiphospholipid antibodies were examined. Both IgG anti-cardiolipin antibody (ELISA) and IgG anti-cardiolipin-β2 -glycoprotein I complex antibody (ELISA) were positive. When PVT is detected in a patient with cirrhosis, it might be necessary to examine antiphospholipid antibodies to clarify the cause of PVT.

Clifford BD, Donahue D, Smith L et al (1995) High prevalence of serological markers of autoimmunity in patients with chronic hepatitis C. Hepatology 21:613–619PubMed

Cacoub P, Musset L, Amoura Z et al (1997) Anticardiolipin, anti-beta2-glycoprotein I, and antinucleosome antibodies in hepatitis C virus infection and mixed cryoglobulinemia. Multivirc Group. J Rheumatol 24:2139–2144PubMed

Dahnert Wolfgang (2007) Portal vein thrombosis. In: Dahnert Wolfgang (ed) Radiology review manual, 6th edn. Lippincott Wiliam & Wilkins, Philadelphia, p 746

Denninger MH, Chait Y, Casadevall N et al (2000) Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors. Hepatology 31:587–591. doi:10.1002/hep.510310307 PubMedCrossRef

Uskudar O, Akdogan M, Sasmaz N (2008) Etiology and portal vein thrombosis in Budd-Chiari syndrome. World J Gastroenterol 14:2858–2862. doi:10.3748/wjg.14.2858 PubMedCrossRef

Insko EK, Haskal ZJ (1997) Antiphospholipid syndrome: patterns of life-threatening and severe recurrent vascular complications. Radiology 202:319–326PubMed

Miyakis S, Lockshin MD, Atsumi T et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 4:295–306. doi:10.1111/j.1538-7836.2006.01753.x PubMedCrossRef

Sthoeger ZM, Fogel M, Smirov A et al (2000) Anticardiolipin autoantibodies in serum samples and cryoglobulins of patients with chronic hepatitis C infection. Ann Rheum Dis 59:483–486. doi:10.1136/ard.59.6.483 PubMedCrossRef

Sene D, Piette JC, Cacoub P (2008) Antiphospholipid antibodies, antiphospholipid syndrome and infections. Autoimmun Rev 7:272–277. doi:10.1016/j.autrev.2007.10.001 PubMedCrossRef

10.

Woitas RP, Stoschus B, Terjung B et al (2005) Hepatitis C-associated autoimmunity in patients coinfected with HIV. Liver Int 25:1114–1121. doi:10.1111/j.1478-3231.2005.01159.x PubMedCrossRef

11.

Dudek A, Dudziak M, Sulek M et al (2006) Serological markers of arthritis in patients with chronic viral hepatitis. Pol Merkur Lekarski 20:404–407PubMed

12.

Cojocaru IM, Corocaru M, Iacob SA (2005) High prevalence of anticardiolipin antibodies in patients with asymptomatic hepatitis C virus infection associated acute ischemic stroke. Rom J Intern Med 43:89–95PubMed

13.

Harada M, Fujisawa Y, Sakisaka S et al (2000) High prevalence of anticardiolipin antibodies in hepatitis C virus infection: lack of effects on thrombocytopenia and thrombotic complications. J Gastroenterol 35:272–277. doi:10.1007/s005350050345 PubMedCrossRef

14.

Zachou K, Liaskos C, Christodoulou DK et al (2003) Anti-cardiolipin antibodies in patients with chronic viral hepatitis are independent of beta2-glycoprotein I cofactor or features of antiphospholipid syndrome. Eur J Clin Invest 33:161–168. doi:10.1046/j.1365-2362.2003.01110.x PubMedCrossRef

15.

Loizou S, Singh S, Wypkema E et al (2003) Anticardiolipin, anti-beta(2)-glycoprotein I and antiprothrombin antibodies in black South African patients with infectious disease. Ann Rheum Dis 62:1106–1111. doi:10.1136/ard.62.11.1106 PubMedCrossRef

16.

Ramos-Casals M, Cervera R, Lagrutta M et al (2004) Clinical features related to antiphospholipid syndrome in patients with chronic viral infections (hepatitis C virus/HIV infection): description of 82 cases. Clin Infect Dis 38:1009–1016. doi:10.1086/382537 PubMedCrossRef

17.

Cervera R, Piette JC, Font J et al (2002) Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1, 000 patients. Arthritis Rheum 46:1019–1027. doi:10.1002/art.10187 PubMedCrossRef

18.

Oksuzoglu G, Bayraktar Y, Arslan S et al (2003) Portal vein thrombosis in cirrhotics: related with anticardiolipin antibodies? Hepatogastroenterol 50:1527–1530

19.

Zachou K, Liaskos C, Rigopoulou E et al (2006) Presence of high avidity anticardiolipin antibodies in patients with autoimmune cholestatic liver diseases. Clin Immunol 119:203–212. doi:10.1016/j.clim.2006.01.002 PubMedCrossRef

20.

Ogimoto A, Sekiya M, Fukuda J et al (2000) Antiphospholipid syndrome with acute myocardial infarction and portal vein occlusion: a case report. Jpn Circ J 64:468–470. doi:10.1253/jcj.64.468 PubMedCrossRef

21.

Pati HP, Srivastava A, Sahni P (2003) Extra hepatic portal vein thrombosis in a child associated with lupus anticoagulant. J Trop Pediatr 49:191–192. doi:10.1093/tropej/49.3.191 PubMedCrossRef

22.

Higa M, Kojima M, Ohnuma S et al (2001) Portal and mesenteric vein and inferior vena cava thrombosis associated with antiphospholipid syndrome. Intern Med 40:1245–1249. doi:10.2169/internalmedicine.40.1245 PubMedCrossRef

23.

Hirohata Y, Murata A, Abe S et al (2001) Portal vein thrombosis associated with antiphospholipid syndrome. J Gastroenterol 36:574–578. doi:10.1007/s005350170063 PubMedCrossRef

Title: Portal vein thrombosis in a patient with hepatitis C virus-related cirrhosis complicated with antiphospholipid syndrome
Authors: Yohei Kida
Etsuko Maeshima
Yoichi Yamada
Publication date: 01-10-2009
Publisher: Springer-Verlag
Published in: Rheumatology International / Issue 12/2009
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-009-0856-0

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Portal vein thrombosis in a patient with hepatitis C virus-related cirrhosis complicated with antiphospholipid syndrome

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2009

Differences between the early and advanced stages of rheumatoid arthritis in the expression of EDA-containing fibronectin

Neuropsychiatric manifestations and antiphospholipid antibodies in pediatric onset lupus: 14 years of experience from a tertiary center of North India

Identification of candidate genes for susceptibility to reactive arthritis

Rituximab in life threatening antisynthetase syndrome

Efficacy of SLZ and MTX (alone or combination) on the treatment of active sacroiliitis in early AS

Portal vein thrombosis in adult-onset Still’s disease: a case report and literature review

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page