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Updated: Jan 17, 2026

Stenosis of the Inferior Vena Cava: A Murine Model of Deep Vein Thrombosis
Published on: December 22, 2017
Congenital Inferior Vena Cava Atresia Unmasked by Pyrexia and Extensive Bilateral Deep Vein Thrombosis in a Young
Daya Mani Jacob1, Divyashri Ramanathan Nagarajan1, Diana George2
1Internal Medicine, Burjeel Medical City, Abu Dhabi, ARE.
Abstract:
A previously healthy, 22-year-old male presented with a one-month history of high-grade intermittent fever, low back pain, and unintentional weight loss. Initial workup revealed markedly elevated C-reactive protein and D-dimer levels with extensive bilateral deep vein thrombosis (DVT). Imaging studies identified atresia of the intrahepatic inferior vena cava (IVC) with prominent collateral venous circulation and associated thrombosis. Genetic testing revealed a methylenetetrahydrofolate reductase (MTHFR) mutation, contributing to a prothrombotic state. Despite empirical antibiotic therapy, the patient's fever and weight loss persisted, which prompted further evaluation. CT pulmonary angiography revealed necrotic mediastinal lymphadenopathy concerning for lymphoma or granulomatous disease. This case highlights the diagnostic complexity of pyrexia of unknown origin (PUO) in young adults and underscores the importance of considering rare congenital vascular anomalies such as IVC atresia in patients presenting with bilateral DVT, especially when accompanied by systemic symptoms and other radiological features.
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