Hepatic Vein Thrombosis in a COVID-19 Patient with Hereditary Thrombophilia: A Case Report

Authors

  • Georges Chedid, MD Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University
  • Rita Khoury, MD Division of Hematology/Oncology, Lebanese American University Medical Center – Rizk Hospital, Beirut, Lebanon
  • Hussein Noureldine, MD Gilbert & Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
  • Jad Gerges Harb, MD Gilbert & Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
  • Esther Tannoury, MD Department of Medical Imaging and Interventional Therapeutics, Lebanese American University Medical Center – Rizk Hospital, Beirut, Lebanon
  • Sahar Semaan, MD Department of Medical Imaging and Interventional Therapeutics, Lebanese American University Medical Center – Rizk Hospital, Beirut, Lebanon
  • Tamina Elias Risk, MD Department of Medical Imaging and Interventional Therapeutics, Lebanese American University Medical Center – Rizk Hospital, Beirut, Lebanon
  • Hady Ghanem, MD Division of Hematology/Oncology, Lebanese American University Medical Center – Rizk Hospital, Beirut, Lebanon

DOI:

https://doi.org/10.38179/ijcr.v3i1.120

Keywords:

Factor V Leiden, MTHFR mutation, thrombophilia, COVID-19, Case report

Abstract

Background: COVID-19 is an infection secondary to the novel SARS-COV-2 virus with a well-established increased risk for thrombotic events. However, the interaction between COVID-19 and other patient-specific hereditary or acquired thrombophilias remains a poorly explored area.

Case Presentation: We herein report a case of a 23-year-old Caucasian female with known risk factors for coagulopathy (smoking, oral contraceptives, anti-phospholipid (aPL) antibodies, heterozygous Factor V Leiden mutation, and homozygous methylenetetrahydrofolate reductase (MTHFR) mutation) who developed a Budd-Chiari syndrome after testing positive for COVID-19. To our knowledge, this is the first report of a case of splanchnic vein thrombosis in a COVID-19 patient with the above risk factors.

Conclusion: Such a presentation underscores the additional increased thrombotic risk attributed to COVID-19 infections in the setting of underlying hereditary or acquired thrombophilias.

References

Gerges Harb J, Noureldine HA, Chedid G, et al. SARS, MERS and COVID-19: clinical manifestations and organ-system complications: a mini review. Pathog Dis. 2020;78(4):ftaa033. PMID: 32633327. https://doi.org/10.1093%2Ffemspd%2Fftaa033

Noureldine, H., Chedid, G. ., Gerges Harb, J., Nour-Eldine , W. ., Nour Eldine, M. ., Noureldine, M. H., Abou Abdallah, D., & Falco Chedid, N. . (2021). SARS, MERS, COVID-19: Identification of Patients at a Higher Risk: A Narrative Review. International Journal of Clinical Research, 2(1), 57-70. https://doi.org/10.38179/ijcr.v2i1.47

Cervera R. Antiphospholipid syndrome. Thromb Res. 2017;151 Suppl 1:S43-S47. PMID: 28262233. https://doi.org/10.1016/s0049-3848(17)30066-x

Varga EA, Sturm AC, Misita CP, Moll S. Cardiology patient pages. Homocysteine and MTHFR mutations: relation to thrombosis and coronary artery disease. Circulation. 2005;111(19):e289-e293. PMID: 15897349. https://doi.org/10.1161/01.cir.0000165142.37711.e7

Bansal P. Factor V Leiden and MTHFR mutations as a combined risk factor for hypercoagulability in referred Patients population from Western India. Mol Cytogenet. 2014;7(Suppl 1):P28. Published 2014 Jan 21. https://doi.org/10.1186%2F1755-8166-7-S1-P28

Hanff TC, Mohareb AM, Giri J, Cohen JB, Chirinos JA. Thrombosis in COVID-19. Am J Hematol. 2020;95(12):1578-1589. PMID: 32857878. https://doi.org/10.1002/ajh.25982

Ignat M, Philouze G, Aussenac-Belle L, et al. Small bowel ischemia and SARS-CoV-2 infection: an underdiagnosed distinct clinical entity. Surgery. 2020;168(1):14-16. PMID: 32473831. https://doi.org/10.1016%2Fj.surg.2020.04.035

La Mura V, Artoni A, Martinelli I, et al. Acute Portal Vein Thrombosis in SARS-CoV-2 Infection: A Case Report. Am J Gastroenterol. 2020;115(7):1140-1142. PMID: 32618673. https://doi.org/10.14309%2Fajg.0000000000000711

Del Hoyo J, López-Muñoz P, Fernández-de la Varga M, et al. Hepatobiliary and Pancreatic: A fatal case of extensive splanchnic vein thrombosis in a patient with Covid-19. J Gastroenterol Hepatol. 2020;35(11):1853. PMID: 32839984. https://doi.org/10.1111%2Fjgh.15174

de Barry O, Mekki A, Diffre C, Seror M, El Hajjam M, Carlier RY. Arterial and venous abdominal thrombosis in a 79-year-old woman with COVID-19 pneumonia. Radiol Case Rep. 2020;15(7):1054-1057. Published 2020 Apr 29. PMID: 32351657. https://doi.org/10.1016%2Fj.radcr.2020.04.055

Connolly A, Walsh S, Arya R. Palmar digital vein thrombosis in a patient with COVID-19. Clin Exp Dermatol. 2021;46(1):183-184. PMID: 32909279. https://doi.org/10.1111%2Fced.14442

Cavalcanti DD, Raz E, Shapiro M, et al. Cerebral Venous Thrombosis Associated with COVID-19. AJNR Am J Neuroradiol. 2020;41(8):1370-1376. PMID: 32554424. https://doi.org/10.3174/ajnr.a6644

Marietta M, Coluccio V, Luppi M. COVID-19, coagulopathy and venous thromboembolism: more questions than answers. Intern Emerg Med. 2020;15(8):1375-1387. PMID: 32653981. https://doi.org/10.1007/s11739-020-02432-x

Singh B, Kaur P, Maroules M. Splanchnic vein thrombosis in COVID-19: A review of literature. Dig Liver Dis. 2020;52(12):1407-1409. PMID: 33067157. https://doi.org/10.1016%2Fj.dld.2020.09.025

Franco-Moreno A, Piniella-Ruiz E, Montoya-Adarraga J, et al. Portal vein thrombosis in a patient with COVID-19. Thromb Res. 2020;194:150-152. PMID: 32788107. https://doi.org/10.1016/j.thromres.2020.06.019

Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033-2040. PMID: 32339221. https://doi.org/10.1182/blood.2020006000

Axial CT scan images of the lower cuts of the chest (lung window) showing bilateral peripheral ground glass opacities associated with subtle interstitial intralobular septal thickening and lobular consolidation, typical for COVID-19 infection.

Published

2022-08-20

How to Cite

Chedid, G., Khoury, R., Noureldine, H. A., Gerges Harb, J., Tannoury, E., Semaan, S., Elias-Rizk, T., & Ghanem, H. (2022). Hepatic Vein Thrombosis in a COVID-19 Patient with Hereditary Thrombophilia: A Case Report. International Journal of Clinical Research, 3(1), 127-131. https://doi.org/10.38179/ijcr.v3i1.120

Issue

Vol. 3 No. 1 (2023): Volume 3, Issue 1

Section

Articles

Copyright (c) 2022 International Journal of Clinical Research

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.