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World J Gastroenterol. Nov 21, 2013; 19(43): 7813-7815
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7813
Published online Nov 21, 2013. doi: 10.3748/wjg.v19.i43.7813
Mesenteric vein thrombosis in a patient heterozygous for factor V Leiden and G20210A prothrombin genotypes
Paras Karmacharya, Madan Raj Aryal, Anthony Donato, Department of Internal Medicine, Reading Health System, West Reading, PA 19611, United States
Author contributions: Karmacharya P and Aryal MR wrote the initial draft; and Donato A provided the subsequent revisions and final manuscript.
Correspondence to: Paras Karmacharya, MD, Department of Internal Medicine, 6th avenue and Spruce Street, Reading Health System, West Reading, PA 19611, United States. paraskarmacharya@gmail.com
Telephone: 1-484-6288255 Fax: 1-484-6289003
Received: July 26, 2013
Revised: August 27, 2013
Accepted: September 3, 2013
Published online: November 21, 2013
Processing time: 145 Days and 0.3 Hours
Revised: August 27, 2013
Accepted: September 3, 2013
Published online: November 21, 2013
Processing time: 145 Days and 0.3 Hours
Core Tip
Core tip: The common presence of two thrombophilic defects increases the thrombotic risk several folds above the risk of a single defect and these tend to occur at an earlier age as seen in our case. Also the risk of recurrent thrombosis is significantly increased among these heterozygotes. Indefinite anticoagulation with oral anticoagulants (goal International Normalized Ratio = 2-3) is recommended for high risk patients like our case with thrombosis at unusual sites (e.g., mesenteric vein), and heterozygosity for both factor V Leiden and prothrombin G20210A mutations. These patients should avoid any hormonal therapy and family members should be screened for underlying prothrombotic condition.