Budd–Chiari syndrome in very young adult patients with polycythemia vera
Autor: | Michal Palumbo, Jacob Maor, Yehezkel Sidi, Gal Goldstein, Ophira Salomon, Yeruham Kleinbaum |
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Rok vydání: | 2013 |
Předmět: |
Male
medicine.medical_specialty Adolescent Budd-Chiari Syndrome Gastroenterology Antithrombins Young Adult Polycythemia vera hemic and lymphatic diseases Internal medicine Occlusion medicine Humans Thrombophilia Young adult Good outcome Child Polycythemia Vera business.industry Incidence (epidemiology) Thrombin Hematology General Medicine Hirudins Janus Kinase 2 medicine.disease Peptide Fragments Recombinant Proteins Surgery Treatment Outcome Liver Direct thrombin inhibitor Mutation Budd–Chiari syndrome Female Complication business |
Zdroj: | Blood Coagulation & Fibrinolysis. 24:848-853 |
ISSN: | 0957-5235 |
Popis: | Polycythemia vera is a Philadelphia chromosome-negative myeloproliferative disorder with incidence of 1% under the age of 25. The Budd-Chiari syndrome (BCS) is a well known complication of polycythemia vera even in children, and characterized by occlusion of hepatic outflow. A computerized archive search of medical records at Sheba Medical Center of the past three decades of patients with polycythemia vera and BCS under the age of 25 years was performed. A work-up for JAK2 V617F mutation and thrombophilia was done. Medical charts and imaging tests were carefully reviewed. Three patients under the age of 22 were finally recruited. Two of those were found in life-threatening condition and improved clinically following treatment with bivalirudin, a direct thrombin inhibitor. It is conceivable that bivalirudin contributed to a favorable outcome of those patients in comparison to historical outcome previously reported. In conclusion, polycythemia vera in the young is not a mild disease since BCS, which is one of its complication, can be fatal even in those age group unrelated to the presence of hereditary thrombophilia. Once BCS occurs, we would suggest giving a trial with bivalirudin before an invasive procedure is planned. |
Databáze: | OpenAIRE |
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