SHM Converge Scientific Abstract ePoster Gallery-Renal and Hepatic Venous Thrombosis Preceding Als Diagnosis: Possible Relationship?

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This document is a Northwell Health case report exploring a possible link between amyotrophic lateral sclerosis (ALS) and unusual venous clots: renal vein thrombosis (RVT) and hepatic vein thrombosis (HVT). Northwell Health describes itself as a major New York health system focused on clinical care, research, education, and community service.<br /><br />The report notes that ALS is a progressive neurodegenerative disease with an average survival of 3–5 years. Because ALS causes increasing immobility, it is already associated with venous thromboembolism, but RVT and HVT are uncommon and harder to explain by immobility alone.<br /><br />Two patients are presented. The first was a 75-year-old woman with multiple chronic conditions who came in with chest pain, shortness of breath, and reduced exercise tolerance; imaging revealed a hepatic vein thrombus. The second was a 62-year-old man hospitalized for pneumonia, diabetic ketoacidosis, respiratory failure, and later found to have a nonocclusive right renal vein thrombus. In both cases, ALS was diagnosed after the thrombosis.<br /><br />A literature review found no prior PubMed reports linking ALS with RVT or HVT. The authors propose that ALS may create a pro-inflammatory, hypercoagulable state, possibly involving the complement pathway and molecules such as thrombin, HMGB1, DAMPs, and thrombomodulin. They suggest these factors could contribute both to clot formation and neurodegeneration.<br /><br />The main conclusion is that these may be the first reported cases associating ALS with renal or hepatic venous thrombosis. The authors recommend considering ALS in patients with unexplained RVT or HVT and propose that coagulation-related biomarkers may eventually help identify ALS patients at higher risk for thrombosis.

Asset Subtitle

Melissa Neumann

Meta Tag

Author List Julian Azar, Mayuri Ravi, Melissa Neumann

Category Clinical Vignettes

Concept Amyotrophic Lateral Sclerosis

Concept Motor Neuron Degeneration

Concept Venous Thromboembolism

Concept Clinical Course

Concept Renal Vein Thrombosis

Distinguished Non-Finalist

Presenter Organization Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Presenting Author Melissa Neumann

Track Adult

Keywords

amyotrophic lateral sclerosis

ALS

renal vein thrombosis

hepatic vein thrombosis

venous thromboembolism

hypercoagulable state

Northwell Health

case report

complement pathway

thrombomodulin

Amyotrophic Lateral Sclerosis

Motor Neuron Degeneration

Venous Thromboembolism

Clinical Course

Renal Vein Thrombosis