Budd-Chiari Syndrome as an Initial Presentation of Antiphospholipid Syndrome in a Male

Abstract

In Budd-Chiari Syndrome (BCS) there is narrowing and obstruction of the veins of the hepatic veins. Patients have upper quadrant abdominal pain, hepatomegaly and/or ascites. Authors hereby, discuss a case report of a 20-year-old male with history of abdominal pain, progressive distension of abdomen and mild jaundice for two months. He had hepatic vein thrombosis as well as lupus anticoagulant and was positive for anti beta 2-glycoprotein I antibody indicative of antiphospholipid syndrome. The patient was worked up for hypercoagulable states in view of unusual site of venous thrombus. Patient recovered after being treated with prolonged anticoagulation and hepatic vein stenting. The link between antiphospholipid syndrome and BCS is well documented in the literature, but occurrence of BCS due to primary antiphospholipid syndrome is rare. Early identification, treatment of underlying cause can prevent chronic BCS and liver cirrhosis.

Keywords

• anticoagulants
• hepatitis
• hepatic vein stenting
• hepatic vein thrombosis