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Unusual Complication of Crohn's Disease: Portal Hypertension Related with Rapid Progression of Portal Vein and Superior Mesenteric Vein Thrombosis

크론병의 드문 합병증: 급성 간문맥고혈압으로 발현한 간문맥 및 상장간막정맥 혈전증

  • Oh, Da Yeon (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Jung, Hye Kyung (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Kwon, Kyoung Joo (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Ryu, Jae In (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Song, Myung Eun (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Yoo, Kwon (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Moon, Il Hwan (Department of Internal Medicine, Ewha Womans University School of Medicine)
  • 오다연 (이화여자대학교 의과대학 내과학교실) ;
  • 정혜경 (이화여자대학교 의과대학 내과학교실) ;
  • 권경주 (이화여자대학교 의과대학 내과학교실) ;
  • 류재인 (이화여자대학교 의과대학 내과학교실) ;
  • 송명은 (이화여자대학교 의과대학 내과학교실) ;
  • 유권 (이화여자대학교 의과대학 내과학교실) ;
  • 문일환 (이화여자대학교 의과대학 내과학교실)
  • Received : 2012.04.13
  • Accepted : 2012.10.10
  • Published : 2013.05.01

Abstract

Thromboembolic events are rare among systemic complications of inflammatory bowel disease; however, they are a significant cause of mortality when they occur. Several reports have considered thromboembolic events in patients with ulcerative colitis presenting with venous or arterial thromboembolism, such as cerebral thrombosis, deep vein thrombosis, pulmonary thromboembolism, portal vein thrombosis, or mesenteric vein thrombosis. However, increased coagulability related to Crohn's disease is extremely rare compared with that of ulcerative colitis. We report a case of a 42-year-old man with complicated portal hypertension that occurred due to extensive portal vein and mesenteric vein thrombosis. He had a monozygotic twin brother who was also in remission with Crohn's disease. The patient showed protein C and protein S deficiencies; however, he recovered with early anticoagulation therapy.

염증성 장질환의 전신 합병증 중 혈전색전증은 흔하지 않은 합병증이나 일단 발생하면 혈관합병증뿐 아니라 염증성 장질환을 악화시켜 사망률이 높은 것으로 알려져 있다. 궤양성 대장염에서 혈전색전증은 국내에서도 몇몇 증례가 보고 되었으나 크론병에서 과응고성으로 인한 혈관 합병증의 사례는 극히 드물다. 저자들은 42세 일란성 남자 쌍둥이 형제에서 크론병이 발병하여 관해 상태를 유지하던 중 형에게 복수와 말초부종이 발생하여 혈액응고 장애와 동반된 간문맥 및 상장간맥 혈전증이 진단되어 조기에 항응고제 치료를 하고 호전된 증례를 경험하여, 기존의 국내에 보고되었던 문헌과 함께 보고한다.

Keywords

References

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  1. Cerebral venous thrombosis in a patient with Crohn's disease vol.14, pp.1, 2013, https://doi.org/10.5217/ir.2016.14.1.96