DOI: 10.12890/2025_005153

Budd-Chiari syndrome as the presenting feature of systemic immunoglobulin light chain amyloidosis

Authors

  • João Luís Miranda Serviço de Medicina Interna, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
  • Catarina Salvado Serviço de Medicina Interna, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
  • Francisca Carmo Serviço de Medicina Interna, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
  • Adriana Guedes Serviço de Medicina Interna, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
  • Albina Moreira Serviço de Medicina Interna, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
  • Tiago Guimarães Costa Serviço de Medicina Interna, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal
  • Leonor Silva Serviço de Medicina Interna, Unidade Local de Saúde Gaia e Espinho, Vila Nova de Gaia, Portugal

joaoluisrm@gmail.com

Keywords

Budd-Chiari syndrome, AL amyloidosis, nephrotic syndrome, liver failure

Abstract

Budd-Chiari syndrome (BCS), characterised by hepatic venous outflow obstruction, is frequently associated with hypercoagulable states. Systemic immunoglobulin light chain (AL) amyloidosis, on the other hand, commonly presents with bleeding complications. The association between the two diseases is not common, but some cases have been described in the past. We report a case of a 58-year-old male who presented with lower limb oedema, abdominal distention and severe fatigue, ultimately diagnosed with BCS secondary to systemic AL amyloidosis. This case highlights the rare association between AL amyloidosis and BCS, likely precipitated by a nephrotic syndrome-induced hypercoagulable state, and emphasises the need for clinicians to consider systemic amyloidosis when investigating the aetiology of BCS, even in the absence of typical bleeding manifestations.

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References

  1. Denninger MH, Chait Y, Casadevall N, Hillaire S, Guillin MC, Bezeaud A, et al. Cause of portal or hepatic venous thrombosis in adults: the role of multiple concurrent factors. Hepatology 2000;31:587–591.
  2. Fotiou D, Theodorakakou F, Spiliopoulou S, Gavriatopoulou M, Migkou M, Kanellias N, et al. Thrombotic and bleeding complications in patients with AL amyloidosis. Br J Haematol 2024;204:1816–1824.
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Published

2025-03-10

How to Cite

1.
Miranda JL, Salvado C, Carmo F, Guedes A, Moreira A, Costa TG, et al. Budd-Chiari syndrome as the presenting feature of systemic immunoglobulin light chain amyloidosis. EJCRIM [Internet]. 2025 Mar. 10 [cited 2026 Nov. 3];12(4). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5153

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