Budd-Chiari Syndrome and antithrombin III deficiency

Area of Science:

• Hepatology
• Thrombosis Research
• Pharmacovigilance

Background:

• Budd-Chiari syndrome is a rare hepatic vascular disease characterized by obstruction of hepatic venous outflow.
• Oral contraceptive (OC) use has been implicated as a risk factor for venous thromboembolism.
• Antithrombin III (ATIII) deficiency is a known risk factor for thrombotic events.

Observation:

• A 20-year-old woman with a history of oral contraceptive use presented with acute Budd-Chiari syndrome.
• Her illness onset was abrupt, mimicking fulminant hepatitis, and she died within six months.
• Morphological features suggested a chronic thrombotic process exceeding six months, despite discontinuing OCs two years prior.

Findings:

• The case suggests a potential long-term causal relationship between past oral contraceptive use and the development of Budd-Chiari syndrome.
• Persistently depressed antithrombin III levels were observed in the patient.
• This case highlights a possible link between OC use, ATIII deficiency, and Budd-Chiari syndrome.

Implications:

• This case underscores the importance of considering oral contraceptive history in young women presenting with Budd-Chiari syndrome.
• The findings suggest that oral contraceptives may contribute to a chronic thrombotic process leading to hepatic venous outflow obstruction.
• Further prospective studies are warranted to establish a definitive causal link and elucidate the underlying mechanisms.