Resolution of Budd-Chiari syndrome due to activation of endogenous fibrinolysis that may be induced by weight reduction.

Abstract

We describe a 45-year-old female with polycythemia vera and Leiden factor V mutation, who suffered the subacute form of Budd-Chiari syndrome and was treated with anticoagulants and diuretics. Surprisingly, after 3 months clinical signs of Budd-Chiari syndrome resolved; venography disclosed the resolution of thrombosis in the vena cava inferior and hepatic veins. This was associated with considerable increase of endogenous fibrinolytic activity, documented by a substantial change in the euglobulin clot lysis time, and a decrease of plasminogen activator inhibitor antigen and activity. During the disease the patient followed a diet and significantly reduced her body weight. Putting all data together it could be speculated that weight reduction (along with anticoagulants) considerably activated endogenous fibrinolysis, resulting in spontaneous resolution of Budd-Chiari syndrome. The validity of this explanation should be explored in a larger clinical study.

• Authors: Miso Sabovic, Tomaz Kljucevsek
• Journal: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis (Blood Coagul Fibrinolysis) Vol. 16 Issue 1 Pg. 51-4 (Jan 2005) ISSN: 0957-5235 [Print] England
• PMID: 15650546 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticoagulants
• Diuretics
• Factor V

Topics

• Anticoagulants (administration & dosage)
• Budd-Chiari Syndrome (diagnostic imaging, etiology, therapy)
• Diet Therapy
• Diuretics (administration & dosage)
• Factor V (genetics)
• Female
• Fibrinolysis
• Humans
• Middle Aged
• Polycythemia Vera (complications, diagnostic imaging)
• Radiography
• Vena Cava, Inferior (diagnostic imaging)
• Weight Loss