Postpartum Budd Chiari syndrome: A case report and literature review
DOI:
https://doi.org/10.22516/25007440.451Keywords:
Budd Chiari syndrome, postpartum period, venous thrombosisAbstract
Budd-Chiari syndrome is defined as obstruction of hepatic blood outflow. This obstruction can be located anywhere from the small hepatic veins at the entrance of the inferior vena cava to the right atrium. Most cases are primary Budd-Chiari syndrome which is caused by endoluminal thrombosis. Secondary Budd-Chiari syndrome occurs as the result of extrinsic compression associated with space-occupying lesions such as malignant tumors. Hereditary thrombophilic states are the main risk factors, but since pregnancy and the puerperium are hypercoagulable states, they can be associated with Budd-Chiari syndrome. Nevertheless, the prevalence of this type of case in the literature varies according to the population studied. There have been no studies on the incidence or prevalence of this disease in Colombia. The small number of case reports here have not been related to pregnancy.
We report the case of a patient who developed Budd-Chiari syndrome 12 weeks postpartum. Our report includes management and clinical evolution as well as a review of the literature of cases associated with pregnancy.
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DeLeve LD, Valla DC, Garcia-Tsao G; American Association for the Study Liver Diseases. Vascular disorders of the liver. Hepatology. 2009 May;49(5):1729-64. https://doi.org/10.1002/hep.22772.
Qi X, Han G, Guo X, De Stefano V, Xu K, Lu Z, et al. Review article: the aetiology of primary Budd-Chiari syndrome - differences between the West and China. Aliment Pharmacol Ther. 2016 Dec;44(11-12):1152-1167. https://doi.org/10.1111/apt.13815.
Almdal TP, Sørensen TI. Incidence of parenchymal liver diseases in Denmark, 1981 to 1985: analysis of hospitalization registry data. The Danish Association for the Study of the Liver. Hepatology. 1991 Apr;13(4):650-5. https://doi.org/10.1016/0270-9139(91)92559-Q.
Okuda H, Yamagata H, Obata H, Iwata H, Sasaki R, Imai F, et al. Epidemiological and clinical features of Budd-Chiari syndrome in Japan. J Hepatol. 1995 Jan;22(1):1-9. https://doi.org/10.1016/0168-8278(95)80252-5.
Falter HJ. Deep vein thrombosis in pregnancy and the puerperium: a comprehensive review. J Vasc Nurs. 1997 Jun;15(2):58-62. https://doi.org/10.1016/S1062-0303(97)90002-9.
Ray JG, Chan WS. Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstet Gynecol Surv. 1999 Apr;54(4):265-71.
Mahmoodi BK, Brouwer JL, Ten Kate MK, Lijfering WM, Veeger NJ, Mulder AB, et al. A prospective cohort study on the absolute risks of venous thromboembolism and predictive value of screening asymptomatic relatives of patients with hereditary deficiencies of protein S, protein C or antithrombin. J Thromb Haemost. 2010 Jun;8(6):1193-200. https://doi.org/10.1111/j.1538-7836.2010.03840.x.
Ren W, Li X, Jia J, Xia Y, Hu F, Xu Z. Prevalence of Budd-Chiari Syndrome during Pregnancy or Puerperium: A Systematic Review and Meta-Analysis. Gastroenterol Res Pract. 2015;2015:839875. https://doi.org/10.1155/2015/839875.
Kamel H, Navi BB, Sriram N, Hovsepian DA, Devereux RB, Elkind MS. Risk of a thrombotic event after the 6-week postpartum period. N Engl J Med. 2014 Apr 3;370(14):1307-15. https://doi.org/10.1056/NEJMoa1311485.
Sultan AA, West J, Tata LJ, Fleming KM, Nelson-Piercy C, Grainge MJ. Risk of first venous thromboembolism in and around pregnancy: a population-based cohort study. Br J Haematol. 2012 Feb;156(3):366-73. https://doi.org/10.1111/j.1365-2141.2011.08956.x.
James AH, Bushnell CD, Jamison MG, Myers ER. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol. 2005 Sep;106(3):509-16. https://doi.org/10.1097/01.AOG.0000172428.78411.b0.
Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJ 3rd. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med. 2005 Nov 15;143(10):697-706. https://doi.org/10.7326/0003-4819-143-10-200511150-00006.
Dilawari JB, Bambery P, Chawla Y, Kaur U, Bhusnurmath SR, Malhotra HS, et al. Hepatic outflow obstruction (Budd-Chiari syndrome). Experience with 177 patients and a review of the literature. Medicine (Baltimore). 1994 Jan;73(1):21-36. https://doi.org/10.1097/00005792-199401000-00003.
Rautou PE, Plessier A, Bernuau J, Denninger MH, Moucari R, Valla D. Pregnancy: a risk factor for Budd-Chiari syndrome? Gut. 2009 Apr;58(4):606-8. https://doi.org/10.1136/gut.2008.167577.
Plessier A, Sibert A, Consigny Y, Hakime A, Zappa M, Denninger MH, et al. Aiming at minimal invasiveness as a therapeutic strategy for Budd-Chiari syndrome. Hepatology. 2006 Nov;44(5):1308-16. https://doi.org/10.1002/hep.21354.
Seijo S, Plessier A, Hoekstra J, Dell’era A, Mandair D, Rifai K, et al. Good long-term outcome of Budd-Chiari syndrome with a step-wise management. Hepatology. 2013 May;57(5):1962-8. https://doi.org/10.1002/hep.26306.
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