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Mesenteric vein thrombosis in a patient heterozygous for factor V Leiden and G20210A prothrombin genotypes

Paras Karmacharya1, Madan Raj Aryal, Anthony Donato

  • 1Paras Karmacharya, Madan Raj Aryal, Anthony Donato, Department of Internal Medicine, Reading Health System, West Reading, PA 19611, United States.

World Journal of Gastroenterology
|November 28, 2013
PubMed

Insights

Mesenteric venous thrombosis (MVT) can occur in young patients with simultaneous Factor V Leiden and prothrombin G20210A mutations. Lifelong anticoagulation is crucial for managing this rare but serious condition.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Hematology

Background:

  • Mesenteric venous thrombosis (MVT) is a rare cause of bowel ischemia, accounting for 6%-9% of acute cases.
  • Primary MVT frequency has decreased due to advanced hypercoagulability testing.
  • Factor V Leiden (FVL) and prothrombin G20210A mutations (PGM) are known risk factors for MVT.

Observation:

  • This case report details MVT in a young, previously asymptomatic patient.
  • The patient presented with acute MVT and was found to be heterozygous for both FVL and PGM.

Findings:

  • Simultaneous heterozygosity for FVL and PGM is a rare finding in MVT cases.
  • This genetic profile indicates an increased risk for venous thromboembolism.

Implications:

  • Management requires lifelong anticoagulation, such as warfarin with a target INR of 2-3.
  • Patients with this genetic profile should avoid hormonal contraceptives.
  • Further research is needed on the long-term implications and optimal management strategies for MVT in patients with combined thrombophilic mutations.
Keywords:
AnticoagulationFactor V LeidenHeterozygousMesenteric vein thrombosisOral contraceptivesProthrombin gene

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