J Korean Rheum Assoc.  2007 Dec;14(4):422-426.

Portal Vein Thrombosis Associated with Antiphospholipid Syndrome

• Lim HC
• Lee YB
• Kim MH
• Jahng JH
• Park MC

Abstract

Antiphospholipid syndrome is a disorder characterized by the presence of antiphospholipid antibodies, recurrent arterial and/or venous thromboembolism, and spontaneous abortion. Deep vein thrombosis, pulmonary thromboembolism, and cerebral infarction are major thrombotic event, but portal vein thrombosis, especially in young age male, is rarely reported. A 27-year- old man, without prior thrombotic event, presented with severe abdominal pain for 4 days. Extensive portal vein thrombosis was noted on abdominal CT scan and MR angiography. Lupus anticoagulant was suspected and was confirmed according to the guidelines of the International Society on Thrombosis and Hemostasis and the patient was diagnosed as having primary antiphospholipid syndrome associated with portal vein thrombosis. Intravenous heparin infusion was initiated and switched to warfarin upon discharge. Now the patients is being followed in outpatient clinic and treated with warfarin without any evidence suggesting the recurrence of thrombotic event.

Keyword

Antiphospholipid syndrome; Portal vein thrombosis; Lupus anticoagulant

MeSH Terms

Abdominal Pain
Abortion, Spontaneous
Ambulatory Care Facilities
Angiography
Antibodies, Antiphospholipid
Antiphospholipid Syndrome*
Cerebral Infarction
Female
Hemostasis
Heparin
Humans
Lupus Coagulation Inhibitor
Male
Portal Vein*
Pregnancy
Pulmonary Embolism
Recurrence
Thrombosis
Tomography, X-Ray Computed
Venous Thromboembolism
Venous Thrombosis*
Warfarin
Antibodies, Antiphospholipid
Heparin
Lupus Coagulation Inhibitor
Warfarin

Figure

• 

  Fig. 1. Extensive portal vein thrombosis found on abdominal CT scan. (A) Entire right intrahepatic portal vein is occluded by thrombosis. (B) Total occlusion of main portal vein is observed.

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  Fig. 2. Portal vein flow was not detected due to extensive thrombosis on MR angiography.

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