Abdominal venous thrombosis risk factors

Oct 12 2008

Abdominal venous thrombosis may present as BCS or SVT. Hereditary and acquired risk factors have been implicated in the etiopathogenesis of abdominal venous thrombosis.

Hereditary risk factors for thrombophilia include Factor V Leiden gene mutation, Prothrombin gene mutation, homozygous methyl tetrahydrofolate reductase (MTHFR) gene mutation and deficiencies of coagulation inhibitor Protein C, Protein S and Antithrombin III. There are few studies from South Asian region which have comprehensively evaluated prothrombotic risk factors in BCS and PVT.

A research article to be published on July 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Ashok Chacko at the Christian Medical College & Hospital, Vellore, India investigated the inherited and acquired risk factors causing clotting of blood in abdominal veins.

Thirty-six patients with blood clots in abdominal veins were studied. The patients were divided into BCS group and SVT group based on the veins involved. Twenty patients had SVT, 14 had BCS and 2 had mixed venous involvement. Inherited and acquired risk factors for blood clotting were evaluated in all patients. Overall, 10 patients (28%) had inherited and 10 patients (28%) acquired risk factors. The acquired risk factors were significantly more common in the SVT group while inherited risk factors though higher than controls did not show significant difference between the two groups. Multiple risk factors were present in one (7%) patient with BCS and 3 patients (15%) with SVT. No risk factors were identified in 57% of patients with BCS and 45% of patients with SVT.

Their result indicate that hereditary and acquired risk factors play an important role in etiopathogenesis of abdominal venous hrombosis. Acquired risk factors are significantly more common in patients with SVT while hereditary risk factors are similar in patients with BCS and SVT. Recognition and evaluation of these risk factors may help in therapy and prevention of disease progression. As a significant number of patients lack obvious etiology further research is required to identify as yet unrecognized risk factors.

Reference: Dutta AK, Chacko A, George B, Joseph AJ, Nair SC, Mathews V. Risk factors of thrombosis in abdominal veins. World J Gastroenterol 2008; 14(28): 4518-4522 http://www.wjgnet.com/1007-9327/14/4518.asp

Correspondence to: Dr. Ashok Chacko, MD, MNAMS (Gastro), DM, Professor & Head, Department of Gastrointestinal Sciences, Christian Medical College & Hospital, Vellore 632 004, India. [email protected] Telephone: +91-416-2282148 Fax: +91-416-2232035