Case report
Acute partial Budd-Chiari syndrome and portal vein thrombosis in cytomegalovirus primary infection: a case report
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* Corresponding author: Laurent Spahr Laurent.Spahr@hcuge.ch
1 Gastroenterology and Hepatology, Ospedale Regionale, Lugano, Switzerland
2 Servicio di Medicina Interna, Ospedale Regionale, Lugano, Switzerland
3 Clinical Pathology, University Hospital, Geneva, Switzerland
4 Infectious Diseases, University Hospital, Geneva, Switzerland
BMC Gastroenterology 2006, 6:10 doi:10.1186/1471-230X-6-10
Published: 10 March 2006Abstract
Background
Splanchnic vein thrombosis may complicate inherited thrombotic disorders. Acute cytomegalovirus infection is a rare cause of acquired venous thrombosis in the portal or mesenteric territory, but has never been described extending into a main hepatic vein.
Case presentation
A 36-year-old immunocompetent woman presented with acute primary cytomegalovirus infection in association with extensive thrombosis in the portal and splenic vein. In addition, a fresh thrombus was evident in the right hepatic vein. A thorough evaluation for a hypercoagulable state was negative. The clinical course, biological evolution, radiological and histological findings were consistent with cytomegalovirus hepatitis complicated by a partial acute Budd-Chiari syndrome and portal thrombosis. Therapeutic anticoagulation was associated with a slow clinical improvement and partial vascular recanalization.
Conclusion
We described in details a new association between cytomegalovirus infection and acute venous thrombosis both in the portal vein and in the right hepatic vein, realizing a partial Budd-Chiari syndrome. One should be aware that this rare thrombotic event may be complicated by partial venous outflow block.