Polymorphism Detection of VKORC1 (vitamin K epoxide reductase complex, subunit 1) Gene for Warfarin Dose Adjustment in Egyptian patients with Budd chiari and/or portal vein thrombosis

Abstract

udd–Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction at the level of the hepatic venules, the large hepatic veins, the inferior vena cava till its junction with the right atrium (Valla, 2008). The classic triad of abdominal pain, ascites, and hepatomegaly is observed in the vast majority of patients with Budd-Chiari syndrome, but it is nonspecific (Goel et al., 2015). Warfarin was introduced into clinical practice in the 1950s, and has been the most widely prescribed oral anti-coagulant for prevention and treatment of thrombotic diseases despite its significant side effects as (bleeding tendency, drug drug interaction). Vitamin K epoxide reductase complex subunit1 (VKORC1), a membrane protein located in hepatocytes, has an important role in the anabolism of vitamin K, which is essential for blood coagulation All included patients were subjected to: History taking, full clinical examination, throbmpophilia work up [Fvlm-MTHFR-factor 2-anti thrombin 3-protein c/s-CD55/CD59-jak2-ANA with titre-anti DNA-lupus anticoagulant-anticardiolipin igG/igM-viral markers]