Portal vein thrombosis in cirrhotics: related with anticardiolipin antibodies?

Background/aims: To evaluate the relationship of antiphospholipid antibodies and portal vein thrombosis in cirrhotics.

Methodology: 22 cirrhotics without portal vein thrombosis (Group I), 18 with portal vein thrombosis (Group II) and 20 healthy controls (Group III) were enrolled. Anticardiolipin IgG and IgM antibody concentrations were measured by ELISA and lupus anticoagulant by clotting. Groups were compared according to sex, age, etiology of cirrhosis, prior intraabdominal surgery, Child groups, anticardiolipin IgG, IgM and lupus anticoagulant. Then for all the 40 cirrhotics (Group IV) correlation was tested between anticardiolipin IgM, IgG, lupus anticoagulant and Child groups, etiology of cirrhosis, sex and prior surgery.

Results: In Group I, anticardiolipin IgG concentration was 15.3 (15.9) GPL)/mL and IgM was 8.6 (6.5) MPL/mL. In 6 (27.27%) anticardiolipin IgG, in 6 (27.27%) IgM and in 2 (9.09%) both were high. Lupus anticoagulant was positive in 7 (31.81%). In Group II anticardiolipin IgG concentration was 26.3 (14.7) GPL/mL and IgM was 15.1 (7.2) MPL/mL. In 10 (55.55%) anticardiolipin IgG, in 13 (72.22%) IgM and in 9 (50%) both were high. Lupus anticoagulant was positive in 5 (27.77%). In Group III lupus anticoagulant was positive in 1 (0.5%). Anticardiolipin IgG was 10.3 (5.9) GPL/mL, IgM 5 (3.6) MPL/mL anticardiolipin IgM level was high in 1 (0.5%). Group I and II were similar with respect to lupus anticoagulant, Child groups, prior intraabdominal surgery and etiology of cirrhosis. For anticardiolipin IgG and IgM there was a significant difference between Group I and II, I and III and II and III. In Group IV there was no correlation between prior abdominal surgery, Child groups, sex, etiology and anticardiolipin IgG, IgM or lupus anticoagulant.

Conclusions: Anticardiolipin antibody concentrations were significantly higher in cirrhotics with portal vein thrombosis. Thus anticardiolipin antibodies may play a role in the development of portal vein thrombosis in cirrhosis.