Abstract：
OBJECTIVE: Recent non-malignant non-cirrhotic portal venous system thrombosis (PVT) is a rare condition. Among risk factors for PVT, cytomegalovirus (CMV) disease is usually listed based on a small number of reported cases. The aim of this study was to determine the characteristics and outcomes of PVT associated with CMV disease.
METHODS: We conducted a French multicenter retrospective study comparing patients with recent PVT and CMV disease (\"CMV positive\"; n = 23) to patients with recent PVT for whom CMV testing was negative (\"CMV negative\"; n = 53) or unavailable (\"CMV unknown\"; n = 297).
RESULTS: Compared to patients from the \"CMV negative\" and \"CMV unknown\" groups, patients from the \"CMV positive\" group were younger, more frequently had fever, and had higher heart rate, lymphocyte count and serum ALT levels (p ≤0.01 for all). The prevalence of immunosuppression did not differ between the 3 groups (4%, 4% and 6%, respectively). Extension of PVT was similar between the 3 groups. Thirteen out of 23 \"CMV positive\" patients had another risk factor for thrombosis. Besides CMV disease, the number of risk factors for thrombosis was similar between the 3 groups. Heterozygosity for the prothrombin G20210A gene variant was more frequent in \"CMV positive\" patients (22%) than in the \"CMV negative\" (4%, p = 0.01) and \"CMV unknown\" (8%, p = 0.03) groups. Recanalization rate was not influenced by CMV status.
CONCLUSIONS: In patients with recent PVT, features of mononucleosis syndrome should raise suspicion of CMV disease. CMV disease does not influence thrombosis extension nor recanalization. More than half of \"CMV positive\" patients have another risk factor for thrombosis, with a particular link to the prothrombin G20210A gene variant.
UNASSIGNED: Patients with cytomegalovirus (CMV)-associated portal venous system thrombosis have similar thrombosis extension and evolution as patients without CMV disease. However, patients with CMV-associated portal venous system thrombosis more frequently have the prothrombin G20210A gene variant, suggesting that these entities act synergistically to promote thrombosis.
METHODS: We conducted a French multicenter retrospective study comparing patients with recent PVT and CMV disease (\"CMV positive\"; n = 23) to patients with recent PVT for whom CMV testing was negative (\"CMV negative\"; n = 53) or unavailable (\"CMV unknown\"; n = 297).
RESULTS: Compared to patients from the \"CMV negative\" and \"CMV unknown\" groups, patients from the \"CMV positive\" group were younger, more frequently had fever, and had higher heart rate, lymphocyte count and serum ALT levels (p ≤0.01 for all). The prevalence of immunosuppression did not differ between the 3 groups (4%, 4% and 6%, respectively). Extension of PVT was similar between the 3 groups. Thirteen out of 23 \"CMV positive\" patients had another risk factor for thrombosis. Besides CMV disease, the number of risk factors for thrombosis was similar between the 3 groups. Heterozygosity for the prothrombin G20210A gene variant was more frequent in \"CMV positive\" patients (22%) than in the \"CMV negative\" (4%, p = 0.01) and \"CMV unknown\" (8%, p = 0.03) groups. Recanalization rate was not influenced by CMV status.
CONCLUSIONS: In patients with recent PVT, features of mononucleosis syndrome should raise suspicion of CMV disease. CMV disease does not influence thrombosis extension nor recanalization. More than half of \"CMV positive\" patients have another risk factor for thrombosis, with a particular link to the prothrombin G20210A gene variant.
UNASSIGNED: Patients with cytomegalovirus (CMV)-associated portal venous system thrombosis have similar thrombosis extension and evolution as patients without CMV disease. However, patients with CMV-associated portal venous system thrombosis more frequently have the prothrombin G20210A gene variant, suggesting that these entities act synergistically to promote thrombosis.
摘要：
目的：最近的非恶性非肝硬化门静脉系统血栓形成（PVT）是一种罕见的疾病。在PVT的危险因素中，巨细胞病毒（CMV）疾病通常是根据少数报告病例列出的。这项研究的目的是确定与CMV疾病相关的PVT的特征和结果。
方法：我们进行了一项法国多中心回顾性研究，比较了最近患有PVT和CMV疾病（\“CMV阳性\”；n=23）的患者与CMV检测阴性（\“CMV阴性\”；n=53）或不可用（\“CMV未知\”；n=297）的最近患有PVT的患者。
结果：与“CMV阴性”和“CMV未知”组的患者相比，“CMV阳性”组的患者年龄较小，更经常发烧，心率更高，淋巴细胞计数和血清ALT水平（所有p≤0.01）。3组之间的免疫抑制患病率没有差异（4％，4%和6%，分别)。3组之间PVT的延长相似。23名“CMV阳性”患者中有13名具有血栓形成的另一个危险因素。除了CMV病,3组的血栓形成危险因素数量相似.凝血酶原G20210A基因变异的杂合性在“CMV阳性”患者（22％）比“CMV阴性”患者（4％，p=0.01)和“CMV未知”(8%，p=0.03)组。再通率不受CMV状态的影响。
结论：在最近患有PVT的患者中，单核细胞增多症综合征的特征应引起对CMV疾病的怀疑。CMV疾病不影响血栓形成的扩展或再通。超过一半的“CMV阳性”患者有另一个血栓形成的危险因素，与凝血酶原G20210A基因变体有特殊的联系。
■与巨细胞病毒（CMV）相关的门静脉系统血栓形成的患者与没有CMV疾病的患者具有相似的血栓形成扩展和演变。然而,CMV相关门静脉系统血栓形成的患者更频繁地具有凝血酶原G20210A基因变异，表明这些实体协同作用以促进血栓形成。
方法：我们进行了一项法国多中心回顾性研究，比较了最近患有PVT和CMV疾病（\“CMV阳性\”；n=23）的患者与CMV检测阴性（\“CMV阴性\”；n=53）或不可用（\“CMV未知\”；n=297）的最近患有PVT的患者。
结果：与“CMV阴性”和“CMV未知”组的患者相比，“CMV阳性”组的患者年龄较小，更经常发烧，心率更高，淋巴细胞计数和血清ALT水平（所有p≤0.01）。3组之间的免疫抑制患病率没有差异（4％，4%和6%，分别)。3组之间PVT的延长相似。23名“CMV阳性”患者中有13名具有血栓形成的另一个危险因素。除了CMV病,3组的血栓形成危险因素数量相似.凝血酶原G20210A基因变异的杂合性在“CMV阳性”患者（22％）比“CMV阴性”患者（4％，p=0.01)和“CMV未知”(8%，p=0.03)组。再通率不受CMV状态的影响。
结论：在最近患有PVT的患者中，单核细胞增多症综合征的特征应引起对CMV疾病的怀疑。CMV疾病不影响血栓形成的扩展或再通。超过一半的“CMV阳性”患者有另一个血栓形成的危险因素，与凝血酶原G20210A基因变体有特殊的联系。
■与巨细胞病毒（CMV）相关的门静脉系统血栓形成的患者与没有CMV疾病的患者具有相似的血栓形成扩展和演变。然而,CMV相关门静脉系统血栓形成的患者更频繁地具有凝血酶原G20210A基因变异，表明这些实体协同作用以促进血栓形成。
