Imbalance of Pro- vs. Anti-Coagulation Factors in Chinese Patients with Budd-Chiari Syndrome and Non-Cirrhotic Portal Vein Thrombosis

Background and Aim The coagulation abnormalities in non-cirrhotic Budd-Chiari syndrome (NC-BCS) and noncirrhotic portal vein thrombosis (NC-PVT) are unclear. We conducted this case-control study to investigate the coagulation profile of NC-BCS and NC-PVT in Chinese patients. Methods We measured the levels of factors II, V, VII, VIII, IX, X, XI, XII, protein C (PC), protein S (PS) and antithrombin (AT) in blood samples from 37 NC-BCS patients, 74 NC-PVT patients, and 100 healthy controls. The levels and ratios of pro-and anti-coagulation factors were compared between patients with NC-BCS and healthy controls, between different types of NC-BCS and between NC-PVT and healthy controls. Results In patients with NC-BCS, factor VIII (P< 0.001) was significantly elevated; factor V (P< 0.001), VII (P< 0.001), IX (P = 0.003), X (P< 0.001), XI (P< 0.001), XII (P< 0.001), PC (P< 0.001) and AT (P< 0.001) were significantly decreased; and no difference was observed for factor II (P = 0.088) and PS (P = 0.199) compared with healthy controls. Factor VIII-to-PC (P = 0.008), factor VIII-to-PS (P = 0.037) and factor VIII-to-AT (P = 0.001) were significantly increased; other ratios were significantly reduced or did not show any difference. No differences were observed between different types of NC-BCS for individual pro-and anticoagulation factors or the ratios between them. Among patients with NC-PVT, factor VIII (P< 0.001) was significantly elevated and other factors were significantly decreased. Factor II-to-PC (P< 0.001), factor VIII-to-PC (P< 0.001), factor IX-to-PC (P< 0.001), factor VIII-to-PS (P< 0.001), factor II-to-AT (P< 0.001), factor VIII-to-AT (P< 0.001) and factor IX-to-AT (P< 0.001) were significantly increased; all other ratios for NC-PVT were significantly reduced or did not show any significant difference. Conclusions NC-BCS and NC-PVT are associated with elevated levels of factor VIII and the decreased levels of PC and AT were probably the most significant features of coagulation imbalance. Additionally, NC-PVT was associated with decreased levels of PS.