[Left branch portal vein thrombosis associated with hyperhomocysteinemia]

Gastroenterol Clin Biol. 1999 Dec;23(12):1388-91.
[Article in French]


A 34 year-old man, who was a smoker, was hospitalised because of severe epigastric and right upper quadrant pain. An isolated left branch portal vein thrombosis was diagnosed using ultrasonography and arteriography. Two thrombogenic pathologies were found: i) a latent myeloproliferative syndrome with spontaneous presence of erythroid colony forming unit (CFU-E) in bone marrow culture, normal blood cell count, platelet count and medullogram; ii) a hyperhomocysteinemia associated with low serum folate levels and a methyl tetrahydrofolate reductase mutation. The association of these two factors probably resulted in portal vein thrombosis. This is the first adult case of a portal vein thrombosis associated with hyperhomocysteinemia. Increased homocysteine serum levels could be a previously unrecognized factor for portal vein thrombosis. Homocysteinemia should be systematically investigated in patients with idiopathic portal vein thrombosis since folate supplements could prevent deleterious vascular effects of hyperhomocysteinemia.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Folic Acid / therapeutic use
  • Folic Acid Deficiency / complications
  • Humans
  • Hyperhomocysteinemia / complications*
  • Male
  • Methylenetetrahydrofolate Reductase (NADPH2)
  • Mutation
  • Oxidoreductases Acting on CH-NH Group Donors / genetics
  • Portal Vein*
  • Venous Thrombosis / diagnosis*
  • Venous Thrombosis / etiology


  • Folic Acid
  • Oxidoreductases Acting on CH-NH Group Donors
  • Methylenetetrahydrofolate Reductase (NADPH2)