Abstract
BACKGROUND: The factor V Leiden (FVL) mutation has been shown to be the most frequent cause of hereditary thrombophilia. The prevalence of the mutation in patients with Budd-Chiari syndrome (BCS) and portal vein thrombosis (PVT) has not been fully elucidated. AIMS: To investigate the association between the FVL mutation and BCS and PVT. PATIENTS: Thirty patients with BCS, 32 patients with PVT, and a control group of 54 patients with liver disorders and no history of thrombosis. METHODS: The factor V gene was analysed for the presence of the FVL mutation by a polymerase chain reaction (PCR) technique. The presence of the mutation was confirmed by DNA sequencing. RESULTS: Seven (23%) patients with BCS, one (3%) patient with PVT, and three (6%) patients in the control group were identified as having the FVL mutation. There of the BCS patients had coexisting hypercoagulable states. The prevalence of the FVL mutation was significantly higher in patients with BCS compared with patients with PVT and controls (p < 0.04). The FVL mutation was the second most common aetiology associated with BCS. CONCLUSION: The FVL mutation is an important factor in the pathogenesis of BCS and screening for the disorder must be included in the investigation of patients presenting with this condition. In contrast, the FVL mutation is not a major predisposing factor in the pathogenesis of PVT.
Full text
PDF


Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Beauchamp N. J., Daly M. E., Hampton K. K., Cooper P. C., Preston F. E., Peake I. R. High prevalence of a mutation in the factor V gene within the U.K. population: relationship to activated protein C resistance and familial thrombosis. Br J Haematol. 1994 Sep;88(1):219–222. doi: 10.1111/j.1365-2141.1994.tb05005.x. [DOI] [PubMed] [Google Scholar]
- Belli L., Romani F., Sansalone C. V., Aseni P., Rondinara G. Portal thrombosis in cirrhotics. A retrospective analysis. Ann Surg. 1986 Mar;203(3):286–291. doi: 10.1097/00000658-198603000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bertina R. M., Koeleman B. P., Koster T., Rosendaal F. R., Dirven R. J., de Ronde H., van der Velden P. A., Reitsma P. H. Mutation in blood coagulation factor V associated with resistance to activated protein C. Nature. 1994 May 5;369(6475):64–67. doi: 10.1038/369064a0. [DOI] [PubMed] [Google Scholar]
- Bertina R. M., Reitsma P. H., Rosendaal F. R., Vandenbroucke J. P. Resistance to activated protein C and factor V Leiden as risk factors for venous thrombosis. Thromb Haemost. 1995 Jul;74(1):449–453. [PubMed] [Google Scholar]
- Dahlbäck B., Carlsson M., Svensson P. J. Familial thrombophilia due to a previously unrecognized mechanism characterized by poor anticoagulant response to activated protein C: prediction of a cofactor to activated protein C. Proc Natl Acad Sci U S A. 1993 Feb 1;90(3):1004–1008. doi: 10.1073/pnas.90.3.1004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Denninger M. H., Beldjord K., Durand F., Denié C., Valla D., Guillin M. C. Budd-Chiari syndrome and factor V Leiden mutation. Lancet. 1995 Feb 25;345(8948):525–526. doi: 10.1016/s0140-6736(95)90625-8. [DOI] [PubMed] [Google Scholar]
- Koeleman B. P., Reitsma P. H., Allaart C. F., Bertina R. M. Activated protein C resistance as an additional risk factor for thrombosis in protein C-deficient families. Blood. 1994 Aug 15;84(4):1031–1035. [PubMed] [Google Scholar]
- Mahmoud A. E., Mendoza A., Meshikhes A. N., Olliff S., West R., Neuberger J., Buckels J., Wilde J., Elias E. Clinical spectrum, investigations and treatment of Budd-Chiari syndrome. QJM. 1996 Jan;89(1):37–43. doi: 10.1093/oxfordjournals.qjmed.a030135. [DOI] [PubMed] [Google Scholar]
- Mahmoud A. E., Mendoza A., Meshikhes A. N., Olliff S., West R., Neuberger J., Buckels J., Wilde J., Elias E. Clinical spectrum, investigations and treatment of Budd-Chiari syndrome. QJM. 1996 Jan;89(1):37–43. doi: 10.1093/oxfordjournals.qjmed.a030135. [DOI] [PubMed] [Google Scholar]
- Mahmoud A. E., Wilde J. T., Elias E. Budd-Chiari syndrome and factor V Leiden mutation. Lancet. 1995 Feb 25;345(8948):526–526. [PubMed] [Google Scholar]
- Mitchell M. C., Boitnott J. K., Kaufman S., Cameron J. L., Maddrey W. C. Budd-Chiari syndrome: etiology, diagnosis and management. Medicine (Baltimore) 1982 Jul;61(4):199–218. doi: 10.1097/00005792-198207000-00001. [DOI] [PubMed] [Google Scholar]
- Pelletier S., Landi B., Piette J. C., Ekert P., Coutellier A., Desmoulins C., Fadlallah J. P., Herson S., Valla D. Antiphospholipid syndrome as the second cause of non-tumorous Budd-Chiari syndrome. J Hepatol. 1994 Jul;21(1):76–80. doi: 10.1016/s0168-8278(94)80140-1. [DOI] [PubMed] [Google Scholar]
- Prat F., Ouzan D., Trecziak N., Trepo C. Portal and mesenteric thrombosis revealing constitutional protein C deficiency. Gut. 1989 Mar;30(3):416–416. doi: 10.1136/gut.30.3.416. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rees D. C., Cox M., Clegg J. B. World distribution of factor V Leiden. Lancet. 1995 Oct 28;346(8983):1133–1134. doi: 10.1016/s0140-6736(95)91803-5. [DOI] [PubMed] [Google Scholar]
- Ridker P. M., Hennekens C. H., Lindpaintner K., Stampfer M. J., Eisenberg P. R., Miletich J. P. Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke, and venous thrombosis in apparently healthy men. N Engl J Med. 1995 Apr 6;332(14):912–917. doi: 10.1056/NEJM199504063321403. [DOI] [PubMed] [Google Scholar]
- Rosendaal F. R., Koster T., Vandenbroucke J. P., Reitsma P. H. High risk of thrombosis in patients homozygous for factor V Leiden (activated protein C resistance) Blood. 1995 Mar 15;85(6):1504–1508. [PubMed] [Google Scholar]
- Sas G., Blaskó G., Petrö I., Griffin J. H. A protein S deficient family with portal vein thrombosis. Thromb Haemost. 1985 Oct 30;54(3):724–724. [PubMed] [Google Scholar]
- Svensson P. J., Dahlbäck B. Resistance to activated protein C as a basis for venous thrombosis. N Engl J Med. 1994 Feb 24;330(8):517–522. doi: 10.1056/NEJM199402243300801. [DOI] [PubMed] [Google Scholar]
- Valla D., Casadevall N., Huisse M. G., Tulliez M., Grange J. D., Muller O., Binda T., Varet B., Rueff B., Benhamou J. P. Etiology of portal vein thrombosis in adults. A prospective evaluation of primary myeloproliferative disorders. Gastroenterology. 1988 Apr;94(4):1063–1069. doi: 10.1016/0016-5085(88)90567-7. [DOI] [PubMed] [Google Scholar]
- Valla D., Casadevall N., Lacombe C., Varet B., Goldwasser E., Franco D., Maillard J. N., Pariente E. A., Leporrier M., Rueff B. Primary myeloproliferative disorder and hepatic vein thrombosis. A prospective study of erythroid colony formation in vitro in 20 patients with Budd-Chiari syndrome. Ann Intern Med. 1985 Sep;103(3):329–334. doi: 10.7326/0003-4819-103-3-329. [DOI] [PubMed] [Google Scholar]
- Valla D., Denninger M. H., Delvigne J. M., Rueff B., Benhamou J. P. Portal vein thrombosis with ruptured oesophageal varices as presenting manifestation of hereditary protein C deficiency. Gut. 1988 Jun;29(6):856–859. doi: 10.1136/gut.29.6.856. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Valla D., Le M. G., Poynard T., Zucman N., Rueff B., Benhamou J. P. Risk of hepatic vein thrombosis in relation to recent use of oral contraceptives. A case-control study. Gastroenterology. 1986 Apr;90(4):807–811. doi: 10.1016/0016-5085(86)90855-3. [DOI] [PubMed] [Google Scholar]
- Vandenbroucke J. P., Koster T., Briët E., Reitsma P. H., Bertina R. M., Rosendaal F. R. Increased risk of venous thrombosis in oral-contraceptive users who are carriers of factor V Leiden mutation. Lancet. 1994 Nov 26;344(8935):1453–1457. doi: 10.1016/s0140-6736(94)90286-0. [DOI] [PubMed] [Google Scholar]
- Zöller B., Berntsdotter A., García de Frutos P., Dahlbäck B. Resistance to activated protein C as an additional genetic risk factor in hereditary deficiency of protein S. Blood. 1995 Jun 15;85(12):3518–3523. [PubMed] [Google Scholar]
- Zöller B., Svensson P. J., He X., Dahlbäck B. Identification of the same factor V gene mutation in 47 out of 50 thrombosis-prone families with inherited resistance to activated protein C. J Clin Invest. 1994 Dec;94(6):2521–2524. doi: 10.1172/JCI117623. [DOI] [PMC free article] [PubMed] [Google Scholar]
