Portal vein thrombosis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Portal vein thrombosis may be caused by inherited prothrombotic disorders and acquired thrombophilic disorders. Less common causes of portal vein thrombosis include acquired conditions such as cirrhosis and hepatocellular carcinoma and procedures such as abdominal surgery or surgical injury of the portal vein axis and splenectomy.
Causes
Life-threatening Causes
- Life-threatening causes of portal vein thrombosis include: hepatocellular carcinoma, and Philadelphia-chromosome negative chronic myeloproliferative disorders (polycythemia vera, essential thrombocythemia, idiopathic myelofibrosis, and unclassifiable myeloproliferative disorders).
Common Causes
Portal vein thrombosis may be caused by:[1][2][3][4][5][6][7][8][9][10][11]
- Inherited prothrombotic disorders
- Acquired thrombophilic disorders
- Primary myeloproliferative disorders
- Paroxysmal nocturnal hemoglobinuria
- Antiphospholipid syndrome
- Increased factor VIII levels
- Thrombin activatable fibrinolysis inhibitor gene (TAFI)
Less Common Causes
Less common causes of portal vein thrombosis include:[12][13][3][14][15]
- Acquired conditions:
- Cirrhosis
- Hepatocellular carcinoma
- Behçet's syndrome
- Recent pregnancy or oral contraceptive use
- Abdominal inflammatory lesions including infection, pancreatitis, and inflammatory bowel disease
- Trauma
- Philadelphia-chromosome negative chronic myeloproliferative disorders (polycythemia vera, essential thrombocythemia, idiopathic myelofibrosis, and unclassifiable myeloproliferative disorders)
- Procedures:
- Abdominal surgery or surgical injury of the portal vein axis
- Endoscopic sclerotherapy
- Transjugular intrahepatic portosystemic shunt
- Splenectomy
- Hepatic resection
- Pancreatic islet cell transplantation
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Oral contraceptive use |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | Cirrhosis, hepatocellular carcinoma, hepatic resection |
| Genetic | No underlying causes |
| Hematologic | Factor V Leiden mutation, factor II gene mutation, protein C deficiency, protein S deficiency, antithrombin III deficiency, primary myeloproliferative disorders, paroxysmal nocturnal hemoglobinemia, antiphospholipid syndrome, increased factor VIII levels, thrombin activatable fibrinolysis inhibitor gene (TAFI), Philadelphia-chromosome negative chronic myeloproliferative disorders (polycythemia vera, essential thrombocythemia, idiopathic myelofibrosis, unclassifiable myeloproliferative disorders) |
| Iatrogenic | Abdominal surgery or surgical injury of the portal vein axis, transjugular intrahepatic portosystemic shunt, abdominal inflammatory lesions including infection, pancreatitis, and inflammatory bowel disease, trauma, procedures, endoscopic sclerotherapy, splenectomy, pancreatic islet cell transplantation |
| Infectious Disease | No underlying causes |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | No underlying causes |
| Obstetric/Gynecologic | Recent pregnancy |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | No underlying causes |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
List the causes of the disease in alphabetical order.
- Abdominal inflammatory lesions including infection, pancreatitis, and inflammatory bowel disease
- Abdominal surgery or surgical injury of the portal vein axis
- Antiphospholipid syndrome
- Antithrombin III deficiency
- Behçet's syndrome
- Cirrhosis
- Endoscopic sclerotherapy
- Factor II gene mutation
- Factor V Leiden mutation
- Hepatic resection
- Hepatocellular carcinoma
- Increased factor VIII levels
- Pancreatic islet cell transplantation
- Paroxysmal nocturnal hemoglobinemia
- Philadelphia-chromosome negative chronic myeloproliferative disorders (polycythemia vera, essential thrombocythemia, idiopathic myelofibrosis, unclassifiable myeloproliferative disorders)
- Primary myeloproliferative disorders
- Protein C deficiency
- Protein S deficiency
- Recent pregnancy or oral contraceptive use
- Splenectomy
- Thrombin activatable fibrinolysis inhibitor gene (TAFI)
- Transjugular intrahepatic portosystemic shunt
- Trauma
References
- ↑ Amitrano L, Guardascione MA, Brancaccio V, Margaglione M, Manguso F, Iannaccone L, Grandone E, Balzano A (2004). "Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis". J. Hepatol. 40 (5): 736–41. doi:10.1016/j.jhep.2004.01.001. PMID 15094219.
- ↑ Janssen HL, Meinardi JR, Vleggaar FP, van Uum SH, Haagsma EB, van Der Meer FJ, van Hattum J, Chamuleau RA, Adang RP, Vandenbroucke JP, van Hoek B, Rosendaal FR (2000). "Factor V Leiden mutation, prothrombin gene mutation, and deficiencies in coagulation inhibitors associated with Budd-Chiari syndrome and portal vein thrombosis: results of a case-control study". Blood. 96 (7): 2364–8. PMID 11001884.
- ↑ 3.0 3.1 Primignani M, Martinelli I, Bucciarelli P, Battaglioli T, Reati R, Fabris F, Dell'era A, Pappalardo E, Mannucci PM (2005). "Risk factors for thrombophilia in extrahepatic portal vein obstruction". Hepatology. 41 (3): 603–8. doi:10.1002/hep.20591. PMID 15726653.
- ↑ Denninger MH, Chaït Y, Casadevall N, Hillaire S, Guillin MC, Bezeaud A, Erlinger S, Briere J, Valla D (2000). "Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors". Hepatology. 31 (3): 587–91. doi:10.1002/hep.510310307. PMID 10706547.
- ↑ Primignani M, Barosi G, Bergamaschi G, Gianelli U, Fabris F, Reati R, Dell'Era A, Bucciarelli P, Mannucci PM (2006). "Role of the JAK2 mutation in the diagnosis of chronic myeloproliferative disorders in splanchnic vein thrombosis". Hepatology. 44 (6): 1528–34. doi:10.1002/hep.21435. PMID 17133457.
- ↑ Sekhar M, McVinnie K, Burroughs AK (2013). "Splanchnic vein thrombosis in myeloproliferative neoplasms". Br. J. Haematol. 162 (6): 730–47. doi:10.1111/bjh.12461. PMID 23855810.
- ↑ Janssen HL, Wijnhoud A, Haagsma EB, van Uum SH, van Nieuwkerk CM, Adang RP, Chamuleau RA, van Hattum J, Vleggaar FP, Hansen BE, Rosendaal FR, van Hoek B (2001). "Extrahepatic portal vein thrombosis: aetiology and determinants of survival". Gut. 49 (5): 720–4. PMC 1728504. PMID 11600478.
- ↑ Bergamaschi GM, Primignani M, Barosi G, Fabris FM, Villani L, Reati R, Dell'era A, Mannucci PM (2008). "MPL and JAK2 exon 12 mutations in patients with the Budd-Chiari syndrome or extrahepatic portal vein obstruction". Blood. 111 (8): 4418. doi:10.1182/blood-2008-02-137687. PMID 18398061.
- ↑ Romano F, Caprotti R, Scaini A, Conti M, Scotti M, Colombo G, Uggeri F (2006). "Elective laparoscopic splenectomy and thrombosis of the spleno-portal axis: a prospective study with ecocolordoppler ultrasound". Surg Laparosc Endosc Percutan Tech. 16 (1): 4–7. doi:10.1097/01.sle.0000202187.80407.09. PMID 16552370.
- ↑ Yoshiya S, Shirabe K, Nakagawara H, Soejima Y, Yoshizumi T, Ikegami T, Yamashita Y, Harimoto N, Nishie A, Yamanaka T, Maehara Y (2014). "Portal vein thrombosis after hepatectomy". World J Surg. 38 (6): 1491–7. doi:10.1007/s00268-013-2440-8. PMID 24407940.
- ↑ White SA, London NJ, Johnson PR, Davies JE, Pollard C, Contractor HH, Hughes DP, Robertson GS, Musto PP, Dennison AR (2000). "The risks of total pancreatectomy and splenic islet autotransplantation". Cell Transplant. 9 (1): 19–24. PMID 10784062.
- ↑ Qi X, Ren W, De Stefano V, Fan D (2014). "Associations of coagulation factor V Leiden and prothrombin G20210A mutations with Budd-Chiari syndrome and portal vein thrombosis: a systematic review and meta-analysis". Clin. Gastroenterol. Hepatol. 12 (11): 1801–12.e7. doi:10.1016/j.cgh.2014.04.026. PMID 24793031.
- ↑ Koshy A, Jeyakumari M (2007). "High FVIII level is associated with idiopathic portal vein thrombosis in South India". Am. J. Med. 120 (6): 552.e9–11. doi:10.1016/j.amjmed.2006.02.016. PMID 17524760.
- ↑ Chamouard P, Pencreach E, Maloisel F, Grunebaum L, Ardizzone JF, Meyer A, Gaub MP, Goetz J, Baumann R, Uring-Lambert B, Levy S, Dufour P, Hauptmann G, Oudet P (1999). "Frequent factor II G20210A mutation in idiopathic portal vein thrombosis". Gastroenterology. 116 (1): 144–8. PMID 9869612.
- ↑ Dentali F, Galli M, Gianni M, Ageno W (2008). "Inherited thrombophilic abnormalities and risk of portal vein thrombosis. a meta-analysis". Thromb. Haemost. 99 (4): 675–82. doi:10.1160/TH07-08-0526. PMID 18392325.