An “unmodifiable” risk factor that has been modified

  • Vincenzo Ronca
  • Gian Marco PoddaEmail author
  • Marco Cattaneo
IM - Case Record

Case presentation

Dr. Ronca: During a follow-up visit on May 2016, a 41 year old man with chronic HBV and HDV hepatitis in cirrhotic evolution underwent an abdomen US scan, which revealed the presence of superior mesenteric vein thrombosis extending to the portal trunk, not present at an US scan performed 3 months before. The finding was incidental, as the patient was asymptomatic. His Child–Pugh–Turcotte score was B7 and his Meld score 17. A screening for thrombophilia evidenced the presence of heterozygous 1691G → A substitution in F5, encoding for mutant R506Q Factor V (Factor V Leiden) [1]. This mutation, which affects about 4% of the Caucasian population [2], renders Factor Va (activated factor V) resistant to degradation by activated C protein (APC) and increases the risk for venous thrombosis by about 3–7% [1, 2]. “APC resistance” can be detected by a specific laboratory test, which measures the ability of exogenous APC to prolong the prothrombin time (PT) of a plasma sample....


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Statement of human and animal rights

The study was conducted according to the principle of Declaration of Helsinki.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  1. 1.Divisione Di Epatologia E GastroenterologiaASST Santi Paolo E Carlo, Università Degli Studi Di MilanoMilanoItaly
  2. 2.U.O. Medicina III, ASST Santi Paolo e Carlo, Dipartimento di Scienze della SaluteUniversità degli Studi di MilanoMilanoItaly

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