Yousif Elamein, Dahawi Elamin, Premraj Sarah, Melki Wissem
Derriford Hospital, University Hospitals Plymouth NHS foundation Trust, Plymouth, UK.
Al-Ahli Hospital, Doha, Qatar.
Arch Clin Cases. 2024 May 14;11(1):16-18. doi: 10.22551/2024.42.1101.10280. eCollection 2024.
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 thrombophilia should be considered, while discontinuing any offending medications.
已证明感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）易引发血栓栓塞事件。在患有潜在遗传性或获得性血栓前状态的人群中，此类血栓形成的风险会进一步增加。作者介绍了一位30岁的女性，她在从轻度新型冠状病毒肺炎（COVID-19）感染康复三天后出现急性腹痛。她也在服用口服避孕药。实验室检查显示炎症标志物升高，腹部增强CT扫描显示门静脉血栓形成（PVT）。由于血栓形成的部位不寻常，进行了血栓形成倾向筛查，检测到杂合子凝血因子V莱顿突变（FVL）。因此，她的门静脉血栓形成归因于三个同时存在的风险因素，即COVID-19感染、口服避孕药使用和FVL突变。她开始接受抗凝治疗，病情有了显著改善。对于在不常见部位出现血栓的患者，应考虑调查近期COVID-19感染的证据，并筛查遗传性和获得性血栓形成倾向，同时停用任何有问题的药物。
