Budd-Chiari syndrome in a 33-year-old woman with hypercoagulable state: A case report

TL;DR

A 33-year-old woman with a hypercoagulable state developed Budd-Chiari syndrome, highlighting the need for early diagnosis and evaluation of clotting disorders.

Contribution

This case report adds to the understanding of BCS by linking it to multiple protein deficiencies and complex comorbidities.

Findings

BCS was diagnosed using Doppler ultrasound and contrast-enhanced CT in a patient with protein deficiencies.

The patient's poor prognosis was due to recurrent ascites and behavioral issues despite anticoagulation.

Early recognition and evaluation of prothrombotic conditions are critical for better BCS outcomes.

Abstract

Budd-Chiari syndrome (BCS) is a rare disorder caused by hepatic venous outflow obstruction, often linked to underlying prothrombotic conditions. This case describes a 33-year-old woman who presented with abdominal pain and ascites and was diagnosed with BCS secondary to deficiencies in protein C, protein S, and antithrombin III. She also had a history of epilepsy, bipolar disorder, and poor medication adherence. Imaging studies, including Doppler ultrasound and contrast-enhanced CT, played a crucial role in confirming the diagnosis. Despite treatment with anticoagulation and diuretics, recurrent ascites and behavioral issues complicated management, leading to a poor prognosis. This case highlights the importance of early recognition, imaging in diagnosis, and evaluation of prothrombotic disorders in patients with BCS to improve outcomes.

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