Background: Although the exact origin of portal vein thrombosis (PVT) is unknown, many studies have linked it to systemic factors like protein C, protein S as well as antithrombin III deficiencies. Other studies have linked it to the elevation of D-dimer and international normalized ratio (INR).
Aim: To evaluate the role of serum protein C, D-dimer and INR as predictors of portal vein thrombosis among cirrhotic patients without hepatocellular carcinoma (HCC).
Patients and methods: This cross-sectional study was conducted on 60 cirrhotic patients, 30 cirrhotic patients without PVT (Group I) and 30 cirrhotic patients with PVT (Group II), who were collected from patients who attended at the outpatient clinic and inpatient of The Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, University of Benha. Levels of protein C, D dimer and INR were assessed among all participants.
Results: This present study showed that protein C level was lower in group II than in group I. In contrast D-dimer and INR levels were higher in group II than in group I. Positive correlation was found between D-dimer, INR, alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine and total bilirubin with severity of liver disease (Child score) especially with cirrhotic patients with PVT. Negative correlation was found between protein C, platelets and serum albumin with severity of liver disease (Child score) especially with cirrhotic patients with PVT.
Conclusion: Decreased protein C, increased D-dimer and increased INR were considered risk factors for formation of PVT among cases with liver cirrhosis. So, it is important to conduct specific imaging techniques in order to confirm the diagnosis and start treatment early.