A 65-year-old man was examined for abdominal pain. Portal and mesenteric vein thromboses were described by ultrasound and computed tomography. No local cause was found. The patient had a positive history of venous thromboembolism. Thrombophilia workup revealed prothrombin G20210A mutation (heterozygous), C677T mutation of methylenetetrahydrofolate reductase gene (homozygous), elevated level of lipoprotein (a), and high level of coagulation factor VIII. Anticoagulation was started and planned for a long-term duration. The etiology of portal vein thrombosis is often multifactorial, with various combinations of systemic factors (inherited or acquired prothrombotic conditions) and local precipitating factors (inflammation, injury to the portal venous system, cancer of the abdominal organs, cirrhosis). The reported prevalence of hypercoagulable states in patients with portal vein thrombosis has been very heterogeneous so far. Some authors support a role of the prothrombin G20210A mutation. In the reported patient, this mutation was revealed in a combination with other hypercoagulable states.

2nd Department of Internal Medicine University Hospital Charles University Pilsen Bory Dr E Benese 13 Pilsen Czech Republic

Clin Appl Thromb Hemost. 2009 Feb;15(1):126 PubMed   Jana, Hirmerova [corrected to Hirmerova, Jana]; Vaclav, Liska [corrected to Liska, Vaclav]; Hynek, Mirka [corrected to Mirka, Hynek]; Zdenek, Chudacek [corrected to Chudacek, Zdenek]; Vladislav, Treska [corrected to Treska, Vladislav]

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