Year 2016 / Volume 108 / Number 9
Case Report
Cryptogenetic liver cirrhosis and prothrombotic mutations - A mere association?

588-591

DOI: 10.17235/reed.2016.3871/2015

María Monereo Muñoz, Selena Gala Aguilera García, Raquel de la Barreda Heusser, Emilio González Arnay, Sonia García Hernández, Emilio González Reimers,

Abstract
Thrombin activation and microthrombosis of intrahepatic portal venules is a common feature in liver cirrhosis, due in part to relative protein C deficiency and altered coagulation-anticoagulation-fibrinolysis balance. Extension of this microthrombotic process to larger portal vessels explains the increased incidence of portal vein thrombosis in liver cirrhosis. Thrombin not only leads to thrombosis, but also activates liver stellate cells and promotes fibrogenesis. Also, ischemia associated with thrombosis up-regulates the expression and secretion of growth factors involved in fibrogenesis. The coincidence in a given patient of prothrombotic mutations, such as factor V Leiden or PAI-1 polymorphisms, can accelerate the fibrogenetic process. We hereby present two cases of liver cirrhosis in which etiologic evaluation was negative except for the finding of a factor V Leiden mutation in one case and the 4G/5G PAI polymorphism in the second case. These observations support the hypothesis that these mutations may be involved in the etiology of some cases of cirrhosis, or, at least, accelerate the evolution of the disease. It is therefore convenient to search for the presence of prothrombotic mutations in patients with cryptogenetic cirrhosis.
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Monereo Muñoz M, Aguilera García S, de la Barreda Heusser R, González Arnay E, García Hernández S, González Reimers E, et all. Cryptogenetic liver cirrhosis and prothrombotic mutations - A mere association?. 3871/2015


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Publication history

Received: 29/05/2015

Accepted: 14/07/2015

Online First: 20/01/2016

Published: 06/09/2016

Article revision time: 42 days

Article Online First time: 236 days

Article editing time: 466 days


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