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Thrombophilia differences in splanchnic vein thrombosis and lower extremity deep venous thrombosis in North America

  • Original Article—Alimentary Tract
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Abstract

Background

The utility of thrombophilia testing in patients with splanchnic vein thrombosis (SpVT) has not previously been rigorously evaluated. The purpose of this study was to characterize differences in the prevalence of thrombophilia in patients with SpVT involving portal (PVT), mesenteric (MVT), splenic (SVT), or hepatic (HVT) veins in isolation or with multisegmental (M-SpVT) involvement compared to patients with lower extremity deep vein thrombosis (DVT).

Methods

An inception cohort of patients with incident SpVT was identified for whom comprehensive thrombophilia testing was performed between 1995 and 2005 and compared to DVT controls.

Results

341 patients with SpVT (mean age 50 ± 16 years, 53 % women) including isolated PVT (n = 112), MVT (n = 67), HVT (n = 22), SVT (n = 11), and M-SpVT (n = 129) involvement and 3621 DVT controls (mean age 55 ± 16 years, 56 % women) had comprehensive thrombophilia testing. The prevalence of abnormal results was similar for SpVT (24.6 %) and DVT (25.9 %) patients. “Strong” thrombophilias were more prevalent among SpVT patients (12.3 vs. 8.5 %, p = 0.0168). Patients with splenic (45.5 %) and mesenteric (41.8 %) thrombosis had the highest thrombophilia prevalence. Protein S deficiency was more common in SpVT patients (3.5 vs. 0.9 %, p < 0.001). In contrast, FV Leiden was more prevalent among DVT patients (15.8 vs. 10.9 %, p = 0.0497).

Conclusion

The prevalence of selected thrombophilia factors differ comparing SpVT and DVT patients. The prevalence is particularly high for patients with splenic and mesenteric vein thrombosis. Whereby the finding of strong thrombophilia impacts duration of anticoagulant therapy, such testing is warranted in the evaluation of patients with unprovoked SpVT.

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Acknowledgments

Biostatistical support was provided by an internal grant from the Mayo Clinic Division of Cardiology.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Mayo Clinic and Foundation for Education and Research, 200 S.W. First Street, Rochester, MN, 55905, USA

    Robert D. McBane, Alfonso J. Tafur & Waldemar E. Wysokinski

  2. Division of Biostatistics, Mayo Clinic, Rochester, MN, 55905, USA

    Diane E. Grill & Joshua P. Slusser

  3. Division of Rehabilitation, Department and Clinic of Orthopedic and Traumatologic Surgery, Wroclaw Medical University, Wroclaw, Poland

    Edyta Sutkowska

  4. First Department and Clinic of General, Gastroenterological and Endocrinological Surgery, Wroclaw Medical University, Wroclaw, Poland

    Krzysztof Sutkowski

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  1. Edyta Sutkowska
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  2. Robert D. McBane
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  4. Krzysztof Sutkowski
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Correspondence to Waldemar E. Wysokinski.

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Sutkowska, E., McBane, R.D., Tafur, A.J. et al. Thrombophilia differences in splanchnic vein thrombosis and lower extremity deep venous thrombosis in North America. J Gastroenterol 48, 1111–1118 (2013). https://doi.org/10.1007/s00535-012-0728-3

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  • DOI: https://doi.org/10.1007/s00535-012-0728-3

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