Thrombophilia Profile in Budd-Chiari Syndrome and Splanchnic Vein Thrombosis: A Study from Western India.

Objective: To estimate the prevalence of inherited prothrombotic risk factors in patients with splanchnic venous thrombosis (SVT) and Budd-Chiari syndrome (BCS) and to compare the risk factor profiles between these two groups.

Methods: In this prospective study, patients with abdominal venous thrombosis were studied. The patients were divided into two groups on the basis of the veins involved; splanchnic venous thrombosis group [portal (PVT), splenic, superior mesenteric veins (SMV)] and Budd-Chiari group (hepatic vein, IVC thrombosis). Thrombophilia profile including protein C, protein S, antithrombin III, factor V Leiden mutation, activated protein C, factor VIII level, CD55, CD59, IgM cardiolipin, IgG cardiolipin, anti-β2 glycoprotein, JAK2 mutation, homocysteine levels, MTHFR and lupus anticoagulant was done in all patients.

Results: Out of 30 patients, 23 patients had SVT, 7 had BCS, including 2 of the 23 patients with SVT had mixed venous thrombosis, PVT and SMV thrombosis. Risk factors were found in 21/30 (70%) patients [17/23 (73.9%) of PVT. 4/7 (57.1% of BCS] and multiple risk factors were overall present in 8/23(34.7%) patients of SVT.

Conclusions: Hereditary risk factors play an important role in the etiopathogenesis of abdominal venous thrombosis and hyperhomocysteinemia and protein S deficiency are the most common risk factors.