Portal Vein Thrombosis and Gut Microbiota: Understanding the Burden

Doina Georgescu,Daniel Lighezan,Mihai Ionita,Mircea Iurciuc,Ioana Ionita,Ana Lascu,Liviu-Andrei Georgescu,Mihaela Muntean

doi:10.37358/rc.19.6.7301

Abstract

Portal vein thrombosis (PVT) continues to be challenging, due to its versatile features and associated clinical pitfalls. This study aimed to explore whether gut microbiota imbalance (GMI) could alter clinical presentation and short term outcome in cirrhotic patients with PVT. We conducted a cross-sectional exploratory study, concerning 50 consecutive cirrhotic patients with PVT recruited during hospitalization. Consecutive to stool microbiological exams, they were assigned into two groups: 25 GMI positive as study group and 25 GMI negative as comparison group. Clinical examination, laboratory work�ups, upper and lower digestive endoscopy, abdominal Duplex ultrasound and CT/MRI were performed Results: Study group displayed significant differences concerning age, interleukin-10 and albumin levels, digestive bleeding, abdominal pain severity and longer hospitalization. In conclusion, dysbiotic patients displayed clinical particularities characterized by older age, higher inflammatory status, hypoalbuminemia, more severe PVT, abdominal pain and digestive bleeding, as well as longer hospitalization duration.

Highlights

Portal vein thrombosis (PVT) continues to be challenging, due to its versatile features and associated clinical pitfalls
The unpaired t test was calculated for statistical distribution and interpretation of p values with confidence interval CI= 95%, p ≤ 0.05 being considered statistically significant. This observational exploratory pilot study was performed on 50 consecutive cirrhotic patients diagnosed with PVT during hospitalization, divided into two groups, after stool exams, as study group (GMI+ patients) and comparison group (GMI -patients)
Baseline demographic and biologic aspects: complete blood count (CBC), ALT, erythrocyte sedimentation rate (ESR),interleukin 10 (IL-10), creatinin, fasting blood sugar( glic),INR, activated partial thromboplastin time (APTT), D-dimers, albumin,total bilirubin (TB) and gut microbiota imbalance (GMI) are summarized in table 1

Summary

Introduction

Portal vein thrombosis (PVT) continues to be challenging, due to its versatile features and associated clinical pitfalls. This study aimed to explore whether gut microbiota imbalance (GMI) could alter clinical presentation and short term outcome in cirrhotic patients with PVT. Laboratory work–ups, upper and lower digestive endoscopy, abdominal Duplex ultrasound and CT/MRI were performed Results: Study group displayed significant differences concerning age, interleukin-10 and albumin levels, digestive bleeding, abdominal pain severity and longer hospitalization. PVT is an infrequent condition, with the real incidence still unknown, depending on diagnostic approach, between 1%, in consecutive autopsy series, to 1.74% in CT exam analysis[11,12].The obstruction, either complete or incomplete, due to a local thrombosis, more or less extended is frequently seen, but other factors (local or distant) may be involved. Experimental part We have conducted a cross-sectional, exploratory study aiming to determine whether GMI could influence clinical presentation and short term outcome in cirrhotic patients with PVT. The assessment of liver cirrhosis severity was based on Child-Pugh score, which employs five variables, two clinical ( ascites and encephalopathy) and three biological (serum albumin, total bilirubin and INR)

Objectives

Methods

Results