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Changing profile of Budd Chiari syndrome in India

C E Eapen1, Thomas Mammen, Vinu Moses

  • 1Department of Gastrointestinal Sciences, Christian Medical College, Vellore 632 004, Tamil Nadu, India. eapen@cmcvellore.ac.in

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|June 15, 2007
PubMed

Insights

Budd Chiari syndrome (BCS) presentation in India has shifted over 30 years. Earlier isolated inferior vena cava (IVC) obstruction is now less common, with combined IVC and hepatic vein obstruction more prevalent, possibly due to earlier diagnosis.

Area of Science:

  • Hepatology
  • Vascular Medicine
  • Epidemiology

Background:

  • Budd Chiari syndrome (BCS) is a rare condition often linked to acquired factors and thrombophilia.
  • Geographical variations in BCS patterns suggest diverse underlying predisposing factors.
  • Previous studies highlighted isolated inferior vena cava (IVC) obstruction as the primary presentation in India.

Purpose of the Study:

  • To review the evolving disease profile of Budd Chiari syndrome in India over the past three decades.
  • To identify changes in the commonest type of venous obstruction.
  • To explore potential reasons for observed shifts in BCS presentation.

Main Methods:

  • Retrospective review of Budd Chiari syndrome cases in India.
  • Analysis of disease patterns over three distinct decades (e.g., 1990s, 2000s, 2010s).
  • Comparison of obstruction types (isolated IVC vs. combined IVC and hepatic vein) across time periods.

Main Results:

  • A significant shift in BCS presentation observed in India over 30 years.
  • Isolated IVC obstruction, once predominant, is now a minority presentation.
  • Combined IVC and hepatic vein obstruction has become the most frequent type.
  • Longer illness duration correlates with IVC obstruction, suggesting earlier diagnosis may influence presentation.

Conclusions:

  • The disease profile of Budd Chiari syndrome in India has changed, with a move towards more complex venous obstruction patterns.
  • Earlier diagnosis, potentially influenced by improved hygiene and sanitation, may explain the shift from isolated IVC obstruction.
  • Predisposing factors like poverty, malnutrition, infections, and filariasis might be less dominant or changing in their influence.

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