<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902019000100150</article-id>
<article-id pub-id-type="doi">10.29193/rmu.35.8</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome de Budd-Chiari asociado a síndrome antifosfolípido]]></article-title>
<article-title xml:lang="en"><![CDATA[Budd-Chiari syndrome associated to antiphospholipid syndrome]]></article-title>
<article-title xml:lang="pt"><![CDATA[Síndrome de Budd-Chiari associado à síndrome antifosfolípidica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Joaquín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mieres]]></surname>
<given-names><![CDATA[Mariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivero]]></surname>
<given-names><![CDATA[Federico]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Elizondo]]></surname>
<given-names><![CDATA[Martín]]></given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Facal]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Maciel  ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Maciel  ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Maciel Clínica Médica &#8220;1&#8221; ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<volume>35</volume>
<numero>1</numero>
<fpage>150</fpage>
<lpage>166</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902019000100150&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902019000100150&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902019000100150&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  el síndrome de Budd-Chiari es una entidad rara definida por la obstrucción al flujo de salida venoso hepático. Se asocia frecuentemente a un estado protrombótico. El diagnóstico y tratamiento oportuno representan un reto para el médico clínico. El objetivo del presente trabajo es reportar un caso clínico de síndrome de Budd-Chiari secundario a síndrome antifosfolípido, asociación infrecuente en la literatura.  Caso clínico:  mujer de 31 años. Ascitis de seis años de evolución, actualmente refractaria. Repercusión general en el último año. Examen físico: lúcida, ictericia universal, hepatomegalia dolorosa, esplenomegalia y ascitis a tensión. Laboratorio: hepatograma con patrón colestásico. Colinesterasa y tasa de protrombina descendidas. Ecografía Doppler abdominal: ascitis severa, hepatomegalia irregular, ecogenicidad aumentada. Esplenomegalia. Obstrucción de vena suprahepática media, estrechamiento de vena suprahepática derecha. Flujo escasamente fásico de baja velocidad, invertido en algunas ramas, hepatófugo. Fibrogastroduodenoscopía: várices esofágicas grado III. Se planteó ascitis secundaria a hipertensión portal, probable síndrome de Budd-Chiari. Los anticuerpos IgM beta2 glicoproteína 1 fueron positivos. Diagnóstico de síndrome antifosfolípido. Se realizó trasplante hepático con buena evolución posterior.  Discusión y conclusiones:  el síndrome de Budd-Chiari es más frecuente en mujeres entre los 30 y 50 años. Debe considerarse como causa de enfermedad hepática, fundamentalmente cuando no existe otra causa evidente. Los estados protrombóticos que más se asocian al síndrome de Budd-Chiari en Occidente son las enfermedades hematológicas. El tratamiento debe ser individualizado según la presentación clínica. El trasplante hepático se plantea como medida de salvataje cuando el resto de los tratamientos han fracasado.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction: Budd-Chiari is a rare condition characterized by the occlusion of the hepatic vein flow out. It is frequently associated to a pro-thrombotic state. Diagnosis and treatment constitute a challenge for clinical doctors. This study aims to report a clinical case of Budd-Chiari syndrome secondary to an antiphospholipid syndrome, a rather unusual association in literature.  Clinical case:  31 year old woman, with 6 years of evolution ascites, evidencing a general affection in the last year. Clinical examination: lucid, universal hyperbilirubinemia (jaundice), painful hepatomegaly, splenomegaly and tension ascites. Laboratory tests: hepatogram with cholestatic pattern, cholinesterase, and reduced prothrombin rate. Abdominal Doppler revealed: severe ascites, irregular hepatomegaly, increased echogenicity. Splenomegaly. Occlusion of the middle suprahepatic vein, narrowing of the right suprahepatic vein. Llow speed scarcely phasic flow, inverse in a few branches, hepatofugal. Fibrogastroduodenoscopy: esophagic varices grade III. Ascites secondary to portal hypertension was suspected, probable Budd Chiari syndrome. Antibodies IgM â2glicoprotein 1 were positive. Diagnosis of antiphospholipid syndrome. Liver transplant was performed with a good evolution of the patient.  Discussion and conclusions:  Budd-Chiari syndrome is more frequent in women between 35 and 50 years old. It needs to be regarded as a cause of liver conditions, in particular when there is no other evident cause. Hematologic diseases are the prothrombotic states more frequently associated to Budd-Chiari syndrome in the western world. Treatment must be based on the clinical presentation. Liver transplant is a rescue/salvage measure when all other treatments fail.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução: a síndrome de Budd-Chiari é uma entidade rara definida pela obstrução do fluxo de saída venoso hepática. Frequentemente está associado a um estado protrombótico. O diagnóstico e o tratamento oportuno são um desafio para o médico clínico. O objetivo deste trabalho é descrever um caso clínico de síndrome de Budd-Chiari secundário à síndrome antifosfolípidica, uma associação pouco frequente na literatura.  Caso clínico:  mulher de 31 anos. Ascite com seis anos de evolução, atualmente refrataria. Repercussão geral no último ano. Exame físico: lúcida, icterícia universal, hepatomegalia dolorosa, esplenomegalia e ascite sob tensão. Laboratório: hepatograma com padrão colestásico. Colinesterase e taxa de protrombina diminuídas. Ultrassonografia Doppler abdominal: ascite severa, hepatomegalia irregular, ecogenicidade aumentada. Esplenomegalia. Obstrução de veia supra-hepática média, estreitamento de veia supra-hepática direita. Fluxo escassamente fásico de baixa velocidade, invertido em algumas ramas, hematófago. Fibrogastroduodenoscopia: varizes esofágicas de grau 3. Diagnóstico presuntivo: ascite secundaria à hipertensão portal, provável síndrome de Budd-Chiari. Anticorpos IgM alfa 2glicoproteína 1 positivos. Diagnóstico de síndrome antifosfolípido. Foi realizado um transplante hepático com boa evolução.  Discussão e conclusões:  a síndrome de Budd-Chiari é mais frequente em mulheres entre os 30 e os 50 anos. Deve ser considerada como causa de enfermidade hepática, fundamentalmente quando não se observa outra causa evidente. Os estados protrombóticos que más se associam à síndrome de Budd-Chiari no Ocidente são as doenças hematológicas. O tratamento deve ser individualizado de acordo com a apresentação clínica. O transplante hepático é uma medida extrema quando outros tratamentos fracassaram.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Síndrome de Budd-Chiari]]></kwd>
<kwd lng="es"><![CDATA[Anticuerpos antifosfolípidos]]></kwd>
<kwd lng="es"><![CDATA[Informes de casos]]></kwd>
<kwd lng="en"><![CDATA[Budd-Chiari Syndrome]]></kwd>
<kwd lng="en"><![CDATA[Antibodies, antiphospholipid]]></kwd>
<kwd lng="en"><![CDATA[Case reports]]></kwd>
<kwd lng="pt"><![CDATA[Síndrome de Budd-Chiari]]></kwd>
<kwd lng="pt"><![CDATA[Anticorpos antifosfolipídeos]]></kwd>
<kwd lng="pt"><![CDATA[Relatos de casos]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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