Volume 55, Issue 1, Pages (July 2011)

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Presentation transcript:

Volume 55, Issue 1, Pages 229-232 (July 2011) Portal vein thrombosis as complication of romiplostim treatment in a cirrhotic patient with hepatitis C-associated immune thrombocytopenic purpura Georg Dultz, Bernd Kronenberger, Alireza Azizi, Ulrike Mihm, Thomas J. Vogl, Ulrike Sarrazin, Christoph Sarrazin, Stefan Zeuzem, Wolf- Peter Hofmann Journal of Hepatology Volume 55, Issue 1, Pages 229-232 (July 2011) DOI: 10.1016/j.jhep.2011.01.020 Copyright © 2011 European Association for the Study of the Liver Terms and Conditions

Fig. 1 The coronal and sagital view of a contrast enhanced CT in a 50-year-old female patient shows partial obstruction of the portal vein. The white arrow indicates narrowing and partial obstruction due to a huge thrombosis located in the extrahepatic portal vein. Journal of Hepatology 2011 55, 229-232DOI: (10.1016/j.jhep.2011.01.020) Copyright © 2011 European Association for the Study of the Liver Terms and Conditions

Fig. 2 The 3D reconstruction of the contrast enhanced CT shows the region of partial obstruction of the portal vein. The reconstruction was done as an attempt to localize the exact level of obstruction which was the region of intersection of the superior mesenteric vein into the portal vein. Journal of Hepatology 2011 55, 229-232DOI: (10.1016/j.jhep.2011.01.020) Copyright © 2011 European Association for the Study of the Liver Terms and Conditions

Fig. 3 Development of platelet count from diagnosis to start of romiplostim therapy and detection of portal vein thrombosis. Journal of Hepatology 2011 55, 229-232DOI: (10.1016/j.jhep.2011.01.020) Copyright © 2011 European Association for the Study of the Liver Terms and Conditions

Fig. 4 Digital subtraction angiography of the patient after cessation of romiplostim and treatment with heparin for 9days. The vascular anatomy of the inferior mesenteric artery and completely recanalized portal venous system are shown. Notice the large portal vein due to portal hypertension and the absence of the huge thrombosis previously shown on the CT. Journal of Hepatology 2011 55, 229-232DOI: (10.1016/j.jhep.2011.01.020) Copyright © 2011 European Association for the Study of the Liver Terms and Conditions