Portal Vein Thrombosis in a Preterm Newborn with Mutation of the MTHFR and PAI-1 Genes and Sepsis by Candida parapsilosis

Objective This report discusses the role of both congenital and acquired risk factors in the pathogenesis of portal vein thrombosis (PVT). Study Design We describe the clinical management and treatment of PVT in a preterm newborn with a homozygous mutation of the methylenetetrahydrofolate reductase (MTHFR) and plasminogen activator inhibitor-1 (PAI-1) genes and sepsis by Candida parapsilosis. Results Although literature data suggest a minor role of genetic factors in thrombophilia in the case of only one mutation, we hypothesize that combined thrombophilic genetic defects may have a cumulative effect and significantly increase the thrombotic risk. Conclusion It could be appropriate to include more detailed analyses of procoagulant and fibrinolytic factors in the diagnostic workup of neonatal thrombosis, also through the investigation of genetic polymorphisms. The anticoagulant therapy and the removal of concurrent risk factors remain basic steps for the adequate management and prevention of complications.

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Thrombotic risk factors in patients with liver cirrhosis: Correlation with disease staging and portal vein thrombosis development

Digestive and Liver Disease ◽

10.1016/s1590-8658(06)80495-0 ◽

2006 ◽

Vol 38 ◽

pp. S183

Author(s):

M.A. Zocco ◽

M. Novi ◽

M.E. Ainora ◽

G. Di Gioacchino ◽

L. Riccardi ◽

...

Keyword(s):

Risk Factors ◽

Liver Cirrhosis ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Thrombotic Risk ◽

Vein Thrombosis ◽

Disease Staging

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Thrombotic risk factors in nonmalignant and noncirrhotic patients with portal vein thrombosis

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0000000000000501 ◽

2016 ◽

Vol 28 (1) ◽

pp. 116-118

Author(s):

Admir Kurtcehajic ◽

Enver Zerem ◽

Ahmed Hujdurovic ◽

Jasmin A. Fejzic

Keyword(s):

Risk Factors ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Thrombotic Risk ◽

Vein Thrombosis

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Thrombophilic genetic factors PAI-1 4G-4G and MTHFR 677TT as risk factors of alcohol, cryptogenic liver cirrhosis and portal vein thrombosis, in a Caucasian population

Gene ◽

10.1016/j.gene.2015.05.034 ◽

2015 ◽

Vol 568 (1) ◽

pp. 85-88 ◽

Cited By ~ 18

Author(s):

Mario D'Amico ◽

Francesca Pasta ◽

Linda Pasta

Keyword(s):

Risk Factors ◽

Liver Cirrhosis ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Genetic Factors ◽

Caucasian Population ◽

Vein Thrombosis ◽

Pai 1

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Homocysteine Serum Levels as Prognostic Marker of Hepatocellular Carcinoma with Portal Vein Thrombosis

Current Molecular Medicine ◽

10.2174/1566524019666190610120416 ◽

2019 ◽

Vol 19 (7) ◽

pp. 532-538

Author(s):

Saverio Latteri ◽

Giulia Malaguarnera ◽

Vito Emanuele Catania ◽

Gaetano La Greca ◽

Gaetano Bertino ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Serum Levels ◽

High Serum ◽

Thrombotic Risk ◽

Mean Values ◽

Vein Thrombosis ◽

Thrombotic Risk Factor

Background: Portal vein thrombosis (PVT) is a common complication of endstage hepatocellular carcinoma (HCC). : The aim of our study was to evaluate the role of Homocysteine (Hcy) in HCC patient with PVT. Hcy is a sulphur amino-acid involved in two pathways, trans-sulphuration and remethylation, that involve vitamins B6, B12 and folates. Methods: We recruited 54 patients with HCC and PVT, 60 patients with HCC and without PVT and 60 control subjects. We measured serum levels of Hcy, folate, vitamins B6 and B12. Results: The comparison between HCC patients with PVT versus HCC without PVT was shown that mean values of Hcy were 6.4 nmol/L (p<0.0073) higher, LDL cholesterol were 4.8 mg/dl (p<0.0079) lower, vitamin B6 were 4.6 nmol/L(p=0.0544) lower, vitamins B 12 were 22.1 pg/ml (p=0.0001) lower. Conclusion: High serum levels of Hcy are an established thrombotic risk factor in the general population. We found significantly higher levels of Hcy in HCC patients with PVT versus both HCC patients without PVT and controls.

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891 PIVOT ROLE OF PAI 1 4G4G IN NON-CIRRHOTIC PORTAL VEIN THROMBOSIS AND BUDD-CHIARI SYNDROME

Journal of Hepatology ◽

10.1016/s0168-8278(11)60893-3 ◽

2011 ◽

Vol 54 ◽

pp. S355 ◽

Cited By ~ 1

Author(s):

M. D'Amico ◽

M. Niceta ◽

P. Sammarco ◽

R. Virdone ◽

E. Sinagra

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Budd Chiari Syndrome ◽

Vein Thrombosis ◽

Chiari Syndrome ◽

Pai 1

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Thrombotic risk factors in patients with liver cirrhosis: Correlation with MELD scoring system and portal vein thrombosis development

Journal of Hepatology ◽

10.1016/j.jhep.2009.03.013 ◽

2009 ◽

Vol 51 (4) ◽

pp. 682-689 ◽

Cited By ~ 239

Author(s):

Maria Assunta Zocco ◽

Enrico Di Stasio ◽

Raimondo De Cristofaro ◽

Marialuisa Novi ◽

Maria Elena Ainora ◽

...

Keyword(s):

Risk Factors ◽

Liver Cirrhosis ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Scoring System ◽

Thrombotic Risk ◽

Vein Thrombosis

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Clostridium Difficile and COVID-19: Novel Risk Factors for Acute Portal Vein Thrombosis

Case Reports in Vascular Medicine ◽

10.1155/2021/8832638 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Venkata Ram Pradeep Rokkam ◽

Gurusaravanan Kutti Sridharan ◽

Rathnamitreyee Vegunta ◽

Radhakrishna Vegunta ◽

Umesha Boregowda ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Abdominal Pain ◽

Clostridium Difficile ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Clostridium Difficile Infection ◽

Thrombotic Risk ◽

Vein Thrombosis ◽

Venous Thromboembolic Events

The COVID-19 pandemic has created an unprecedented global health care crisis. COVID-19 patients are found to have increased thrombotic risk. Despite being on prophylactic anticoagulation, many develop serious arterial and venous thromboembolic events. Emerging reports indicate COVID-19 may be considered a novel risk factor for portal vein thrombosis. Although, intra-abdominal infections are identified as risk factors, clostridium difficile colitis has not been typically seen as a risk factor for PVT. We report a case of an elderly female with a recent diagnosis of COVID-19 and no prior history of cirrhosis or malignancy who presented with diarrhea due to clostridium difficile infection. She developed sudden onset severe abdominal pain during the course of hospitalization. Acute portal vein thrombosis was identified on CT imaging of the abdomen, and she improved well with therapeutic anticoagulation. Acute portal vein thrombosis usually results from a combination of local and systemic prothrombotic risk factors. The combination of local infection by clostridium difficile and COVID-19 coagulopathy led to development of portal vein thrombosis in our patient. To the best of our knowledge, this is the first case of portal vein thrombosis reported in a patient with clostridium difficile infection in the setting of COVID-19 coagulopathy. During the current pandemic, clinicians should strongly consider abdominal imaging in patients presenting with abdominal pain due to clostridium difficile infection in the setting of COVID-19 to rule out complications such as portal vein thrombosis. Early diagnosis and treatment of portal vein thrombosis prevent complications of portal hypertension and intestinal infarctions.

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