S1847 Hyperhomocyteinemia As a New Risk Factor for Unexplaned Portal Vein Thrombosis in Cirrhotic Patients in Eygpt

Abstract

Background/ Aims: Portal vein thrombosis (PVT) in patients with liver cirrhosis is usually associated with hepatocellualar carcinoma. The pathogenesis of non-malignant PVT in cirrhotics has not been specifically studied and risk factors of PVT in this group of patients are still poorly understood. The aim of this study was to ascertain the prevalence and the significance of hyperhomocyteinemia among other risk factors in the development of PVT in cirrhotic patients. Patients and methods: Fifty two subjects were included in this study. Forty two cirrhotic patients; among them 21 had PVT and 21 had liver cirrhosis without PVT. Ten healthy subjects were included as controls. Plasma levels of homocysteine, antithrombin III, protein C and protein S were measured. Factor V Leiden was determined and methylenetetrahydrofolate reductase (MTHFR) C677T gene mutation was detected. Results: Our results revealed that plasma levels of protein C, protein S and antithrombin III were lower in cirrhotic patients with PVT than in those without PVT and controls. Plasma homocysteine level was higher among cirrhotics with PVT compared to those without PVT and controls. Factor V Leiden was detected only in 10% of controls and in 9.52% of cirrhotics with and without PVT whereas MTHFR gene mutation TT (homozygous) was detected in 23.81% of cirrhotics with PVT and not found in other groups. Conclusion: Heyperhomocyteinemia could be considered as a newly recognized risk factor for PVT in cirrhotic patients and should be routinely measured particularly when the etiology of PVT is unclear. These results could be clinically important due to the readily available therapy of folate, vitamin B6 and B12 supplementation that may reduce homocysteine and prevent further thrombotic complications.