Is it advisable to give LMWH to treat PVT?

Question

Hello doctor,

The patient was diagnosed with autoimmune hepatitis for 27 years and portal hypertension for at least 10 years and was recently diagnosed with portal vein thrombosis (almost complete thrombosis to the level of confluency) through a CT scan. The patient takes Azathioprine for treatment for the past 15 years and was previously on steroids when first diagnosed. Liver cirrhosis is present, AFP levels are normal on the last check (four months ago) and have always been. Her PT is normal and albumin levels are low. Now for the treatment of PVT, what is advisable? LMWH or something else?

Answer 1

Hi,

Welcome to icliniq.com.

The information given here (attachment removed to protect patient identity) shows that she has liver cirrhosis. Also, she has portal hypertension. In this setting, treatment should be directed at liver cirrhosis which has ultimately resulted in portal vein thrombosis. The reports are negative for underlying tumor (which needs the CT image to be seen). She may benefit from LMWH (low molecular weight Heparin) if other liver parameters are fine. Else the best option ahead would be liver transplant. I would like to see her complete reports for a detailed discussion.

For more information consult a medical gastroenterologist online