Membranous occlusion of the inferior vena cava

Buecheler, E.; Weber, Kurt

doi:10.1259/0007-1285-47-560-444

Cited by 6 publications

(1 citation statement)

References 8 publications

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“…As the obstruction is above the level of the hepatic veins, portal blood must also par ticipate in this collateral circulation. We did not perform splenoportography in our pa tient, but Buecheler and Weber [5] have shown hepatofugal portal flow in such pa tients [5]. Prolonged exposure of the systemic circulation to gut-derived antigens, including bacterial endotoxins, is presumably the main cause of the hypergammaglobulinemia of pa tients with portal-systemic shunting [6], The stimulatory effect of enteric organisms or their wall lipopolysaccharides is in part due to an antigenic-specific activation of re stricted clones of B cells and in part due to polyclonal B cell activation [7], Immune stimulation by this mechanism could possi bly be related to the presenting symptoms in this patient.…”

Section: Discussionmentioning

confidence: 95%

Membranous Obstruction of the Inferior Vena cava and Systemic Lupus erythematosus

Wilson¹,

Haalebos²,

Laméris³

et al. 1983

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A 37-year-old woman who presented with systemic lupus erythematosus was found to have a membranous obstruction of the inferior vena cava above the hepatic veins, with an extensive collateral circulation. The obstruction was relieved by a renal vein-right atrial interposition graft, and this was followed by disappearance of the anti-nuclear and anti-DNA antibodies. We postulate that the systemic lupus erythematosus might have been provoked by life-long immune stimulation due to bowel-derived antigens bypassing the hepatic reticuloendothelial system and reaching the systemic circulation, or by immune hyperreactivity associated with the abnormal abdominal venous circulation.

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