Complicated course of portal hypertension on the background of primary myelofibrosis: a clinical case

Esophageal varices are a consequence of portosystemic collaterals that develop under conditions of increased pressure between the portal and inferior vena cava. Bleeding from varices significantly worsens the patient’s condition and poses a risk to his life. Portal hypertension is usually considered as complication of liver cirrhosis, but there is a small pool of patients with so-called extrahepatic causes. The second most frequent cause of portal hypertension after cirrhosis is portal vein thrombosis. The article describes a case of clinically significant portal hypertension complicated by esophageal varices, which developed due to portal vein thrombosis after SARS-CoV-2 infection. During additional examination, liver cirrhosis was ruled out, and further clinical search was aimed at identifying other factors of thrombophilia. As a result of the morphological and genetic examination, a diagnosis of primary myelofibrosis was made. Thus, in patients with portal vein thrombosis, the development of clinically significant portal hypertension, the possibility of a myeloproliferative neoplasm should be considered after exclusion of cirrhosis.