Congenital anomaly of the inferior vena cava and factor V Leiden mutation predisposing to deep vein thrombosis

Brooke M Lamparello,1,* Cameron R Erickson,2,* Arun Kulthia,3 Vasudev Virparia,3 Zeyar Thet3 1St George’s University, Grenada, West Indies; 2Northeast Ohio Medical University, Rootstown, OH, USA; 3Department of Medicine, Coney Island Hospital, Brooklyn, NY, USA *These authors contributed equally to this work Abstract: A previously healthy 21-year-old man presented with back pain, bilateral extremity pain, and right lower extremity weakness, paresthesias, and swelling. Sonographic examination revealed diffuse deep vein thrombosis (DVT) in the femoral and popliteal venous system. CT imaging revealed hypoplasia of the hepatic inferior vena cava (IVC) segment with formation of multiple varices and collateral veins around the kidneys. Hematologic workup also discovered a factor V Leiden mutation, further predisposing the patient to DVT. The rare, often overlooked occurrence of attenuated IVC, especially in the setting of hypercoagulable state, can predispose patients to significant thrombosis. Keywords: inferior vena cava (IVC), deep vein thrombosis (DVT), lower extremities, thrombophilic, venograph