Etiology and VTE risk factor distribution in patients with inferior vena cava thrombosis

Linnemann, Birgit; Schmidt, Henriette; Schindewolf, Marc; Erbe, Matthias; Zgouras, Dimitrios; Grossmann, Ralf; Schambeck, C. M.; Lindhoff-Last, Edelgard

doi:10.1016/j.thromres.2008.01.004

Cited by 31 publications

(33 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 In addition, intra-abdominal thrombosis in the absence of underlying disease is strongly associated with myeloproliferative neoplasms, paroxysmal nocturnal hemoglobinuria or antiphospholipid syndrome 3 and, as in our patient's case, guidelines recommend screening for these conditions.…”

Section: Clonal (Autonomous)supporting

confidence: 52%

“…In a case series involving 53 patients with inferior vena cava thrombosis, thrombophilia was the most common risk factor, found in more than half of the patients; overt myeloproliferative neoplasm was found in up to half of the patients with hepatic vein thrombosis and up to one-third of those with extrahepatic portal vein thrombosis. 3 Essential thrombocythemia mostly affects older adults, but about 20% of cases occur in young adults, such as our patient. 18 More than one-third of patients have vasomotor symptoms (e.g., headache, lightheadedness, syncope, atypical chest pain, acral paresthesia or erythromelalgia).…”

mentioning

confidence: 66%

“…In a large registry of venous thromboembolism, 53 of 1770 patients (3.0%) had thrombosis of the inferior vena cava. 3 Thrombosis of the inferior vena cava can be caused by an adjacent tumour (e.g., renal, adrenal, hepatic, pancreatic, retroperitoneal) or local pathology (e.g., congenital membranous web, endovascular devices, external compression, severe infection in an area drained by the vessel). 3 These causes were excluded in our patient, but several factors (organ enlargement, abnormal platelet count and idiopathic intraabdominal venous thrombosis) suggested an underlying disease and mandated a careful search for a thrombophilic disorder, after ruling out reactive thrombocytosis (Box 1).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Unusual venous thrombosis in a 35-year-old man

Schattner

2013

CMAJ

View full text Add to dashboard Cite

A n otherwise healthy 35-year-old man presented to the emergency department with substantial pain in his upper abdomen that had lasted for several days and was radiating to his back. The patient had experienced a similar episode 4 months earlier that had not been investigated.On physical examination, the patient had hypertension (150/105 mm Hg), hepatosplenomegaly and pitting leg edema, with no signs of chronic liver disease. The results of laboratory investigations showed a hemoglobin level of 95 (normal 120-150) Duplex ultrasonography of the patient's abdomen showed an extensive, nearly occlusive thrombus in the infra-and intrahepatic inferior vena cava. The hepatic vein did not appear to be occluded, but the patchy appearance of the liver parenchyma and flow through a collateral vessel were consistent with obstruction of the hepatic outflow tract (Figure 1). Contrast-enhanced computer tomography (CT) and magnetic resonance imaging (MRI) of the abdomen and chest confirmed hepatomegaly (20 cm, with enlargement of the caudate lobe), splenomegaly (20 cm), thrombosis of the inferior vena cava extending to below the renal veins and mild ascites (Figure 2). We saw no congenital membranous web, anomaly or compression of the inferior vena cava. Results of echocardiography (including the proximal inferior vena cava) were normal, and endoscopy showed no varices.We started low-molecular-weight heparin therapy for thrombosis and ramipril for hypertension. The results of tests for heritable and acquired thrombophilia were negative. 1 However, a review of the pa tient's earlier primary care charts showed thrombocytosis (531-741 × 10 9 /L) on 5 routine blood tests over the previous 6 years. The patient's family history was noncontributory.The combination of thrombocytosis, which did not appear to be reactive or cytokine-driven (Box 1), 2 and substantial splenomegaly, despite only mild portal hypertension and thrombosis, suggested myeloproliferative neoplasm. On reviewing the smear of the patient's peripheral blood, we saw large abnormal platelets. Bone marrow aspiration and biopsy showed a hyperplastic marrow with megakaryocyte proliferation, atypia and clustering, increased eosinophils and increased reticulin fibres (grade 1/3). Genetic testing showed the presence of the JAK2 V617F mutation, with low (20%) JAK2 mutant allele burden; the results of testing for the BCR-ABL fusion gene were negative. We diagnosed essential thrombocythemia and started the patient on hydroxyurea (1000 mg/d) and warfarin. After 1 year of follow-up, the patient feels well and remains symptom-free. DiscussionThe patient's pain, edema, cholestatic liver enzymes, renovascular hypertension and proteinCases

show abstract

Section: Clonal (Autonomous)supporting

confidence: 52%

mentioning

confidence: 66%

mentioning

confidence: 99%

See 1 more Smart Citation

Unusual venous thrombosis in a 35-year-old man

Schattner

2013

CMAJ

View full text Add to dashboard Cite

show abstract

“…In the lower venous system, the most common abnormalities are interrupted or duplex IVC, presumably secondary to disrupted embryonic development of the IVC itself. [502][503][504][505][506][507][508][509] However, in the upper venous system, thoracic outlet syndrome, eponymously named Paget-Schroetter syndrome, are believed to be due to chronic trauma to the subclavian vein secondary to reduced anatomic space for the vein usually as a result of an abnormal relationship with the fi rst rib, abnormal fi brous bands or muscle development in athletes . [510][511][512][513][514][515][516][517][518][519] Management of the venous thrombosis and the underlying structural abnormality has included acute anticoagulation; both local and systemic thrombolysis through a number of techniques; percutaneous angioplasty; thrombectomy; venous reconstruction; and in the case of PagetSchroetter syndrome, decompression of the thoracic inlet through removal of relevant bone and muscle.…”

Section: Children With Vte and Structurally Abnormally Venous Systemsmentioning

confidence: 99%

Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

1,211

559

View full text Add to dashboard Cite

“…Budd-Chiari syndrome has been associated with factor V Leiden [22]. The role of genetic risk factors such as factor V Leiden and prothrombin G20210A mutations in migrating thrombophlebitis [8] and thrombosis of the vena cava [23], renal vein [24] and retinal vein [9,14] has not been established.…”

Section: Introductionmentioning

confidence: 99%

Familial risks of unusual forms of venous thrombosis: a nationwide epidemiological study in Sweden

Zöller

Sundquist

et al. 2010

Journal of Internal Medicine

View full text Add to dashboard Cite

Zöller B, Li X, Sundquist J, Sundquist K. (Center for Primary Health Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA). Familial risks of unusual forms of venous thrombosis: a nationwide epidemiological study in Sweden. J Intern Med 2011; 270: 158–165. Abstract. Objective. This is the first nationwide study to determine familial risks of unusual forms of venous thrombosis amongst offspring of affected parents and amongst siblings. Design and settings. The Swedish Multigeneration Register of 0‐ to 75‐year‐old subjects was linked to the Hospital Discharge Register for the period 1987–2007. Standardized incidence ratios (SIRs) were calculated for individuals whose relatives were hospitalized for venous thromboembolism (VTE), as determined by the International Classification of Diseases, compared to those whose relatives were not affected by VTE. Results. The total number of hospitalized patients with VTE was 45 362, of which 1824 (4.0%) were affected by a rare thrombotic condition. The familial SIRs in cases with a history of VTE in parents or siblings were significantly increased for migrating thrombophlebitis (1.81; 95% confidence interval (CI) 1.40–2.31), portal vein thrombosis (2.35; 95% CI 1.77–3.06), vena cava thrombosis (1.96; 95% CI 1.42–2.64) and cerebral venous thrombosis (1.74; 95% CI 1.30–2.28). Budd–Chiari syndrome (SIR, 0.92; 95% CI 0.24–2.38) and renal vein thrombosis (SIR, 1.72; 95% CI 0.62–3.77) were not significantly associated with parental or sibling history of VTE; however, these two conditions were very rare, and therefore, we cannot draw any definite conclusions from this finding. Conclusions. Family history is an important risk factor for most unusual forms of VTE. Moreover, even the paraneoplastic phenomenon, migrating thrombophlebitis (Trousseau’s syndrome), is associated with a family history of VTE. Thus, our data suggest that most rare forms of VTE have a familial background.

show abstract

Etiology and VTE risk factor distribution in patients with inferior vena cava thrombosis

Cited by 31 publications

References 36 publications

Unusual venous thrombosis in a 35-year-old man

Unusual venous thrombosis in a 35-year-old man

Antithrombotic Therapy in Neonates and Children

Familial risks of unusual forms of venous thrombosis: a nationwide epidemiological study in Sweden

Contact Info

Product

Resources

About