Triple Whammy in a Patient with Portal Vein Thrombosis
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http://orcid.org/0000-0002-8644-3827
Elamin Dahawi
Sarah Premraj
http://orcid.org/0000-0003-4852-7752
Wissem Melki
Abstract
Infection with SARS-CoV-2 has been shown to predispose to thromboembolic events. The risk of such thromboses further increases in those with underlying inherited or acquired prothrombotic states.
The authors present a 30-year-old lady who developed acute abdominal pain, three days after recovery from a mild COVID-19 infection. She was also using oral contraceptive pills. Laboratory investigations revealed elevated inflammatory markers, and a contrast-enhanced abdominal CT scan demonstrated portal vein thrombosis (PVT). Due to the unusual site of thrombosis, a thrombophilia screen was performed, which detected a heterozygous Factor V Leiden mutation (FVL). Thus, her PVT was attributed three simultaneous risk factors, namely COVID-19 infection, OCP use and FVL mutation. She was initiated on anti-coagulation, with which she improved significantly.
In patients presenting with thromboses at uncommon sites, investigation for evidence of recent Covid-19 infection and screening for inherited and acquired thrombophilias should be considered, while discontinuing any offending medications.
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SARS-CoV-2, COVID-19, portal vein thrombosis, Factor V Leiden mutation, oral contraceptive
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