Chronic Portal Vein Thrombosis
- Accounts for 5-10% of patients with portal hypertension (Pre-sinusoidal)
- Sinusoidal from cirrhosis is the majority
- Can also have post-sinusoidal from Budd-Chiari
- Most causes associated with cirrhosis, malignancy, infection or myeloproliferative disorder.
- In a patient with a healthy liver, likely due to a prothrombotic state including Factor V Leiden, Protein C Deficiency and Protein S Deficiency
- Frequently presents with varices and ascites
- Often leads to cavernous transformation and collateral formation, potentially making TIPS difficult
Posted 04/05/17 09:27:16 AM by Ying Liu
Protein S Deficiency
- Discovered and isolated in Seattle
- Co-factor for activated protein C to block prothrombin activation and clotting process; deficiency leads to a thrombophilia
- Inherited in an autosomal dominant manner, most mutations are in the PROS1 gene on chromosome 3
- Can test for free protein S, bound protein S and activity (affected by warfarin and NoACs but not heparin/lovenox)
Posted 04/05/17 09:27:39 AM by Ying Liu
TRALI (Transfusion Related Acute Lung Injury)
- Occurs in 1 in 5000 transfused blood components
- Neutrophil sequestration and priming in the lung microvasculature (depends on recipient factors)
- Recipient Neutrophil activation by factors in the donor blood product leading to cytokine release and inflammatory pulmonary edema
- Supportive Care
- Report to Blood Bank so that donor’s blood products can be removed
- Patient can still receive blood products but blood bank will be notified and will monitor next transfusion
Posted 04/05/17 09:28:21 AM by Ying Liu
Created by Christopher Kelly
Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.