Chronic Myeloid Leukemia Presenting as Portal Vein Thrombosis with Esophageal Variceal Bleed—A Rare Presentation

Abstract

Chronic myeloid leukemia, also known as chronic granulocytic leukemia, is a cancer of white blood cells. It is a myeloproliferative disorder characterized by increased and unregulated growth of predominantly myeloid cells in bone marrow and accumulation of these cells in blood. Chronic myeloid leukemia presenting as a thrombus in portal vein with esophageal variceal bleed is extremely rare. We present a case of a 33-year-old female, known case of chronic myeloid leukemia for the past 2 years (on Tab Imatinib 400 mg OD), who presented with massive hematemesis. Emergency endoscopy revealed 3 columns of large esophageal varices with bleeding from one of the varices. Blood transfusion was initiated and endoscopic variceal ligation was done. She was diagnosed to have portal vein thrombosis on portal vein Doppler study with normal liver. Portal vein thrombosis leading to esophageal varices was probably due to hypercoagulability secondary to chronic myeloid leukemia as other tests for hypercoagulable states were negative. There is absolute paucity of presentation in world literature of cases of chronic myeloid leukemia having portal vein thrombosis and variceal bleeding.