Rahul Saha: A Rare Link Between Hypothyroidism and Budd Chiari Syndrome
Rahul Saha, Pharmacokinetics (DMPK) and Clinical Pharmacology for Aera Therapeutics, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in IJAR adding:
“Published in Case Report — Indian Journal of Applied Research (IJAR) of Applied Research (Vol. 16, Issue 04, April 2026)
Budd-Chiari Syndrome Associated with Untreated Hypothyroidism in a Young Female: A Clinical Case Report
Excited to share my latest publication — a clinical case report documenting a rare and diagnostically complex presentation of Budd-Chiari Syndrome (BCS) in a 22-year-old woman whose thyroxine non-adherence likely triggered a prothrombotic cascade leading to hepatic vein thrombosis and IVC involvement.
Key highlights:
- TSH of 12.4 mIU/L at admission — untreated hypothyroidism as a clinically underappreciated thrombotic risk factor
- Triple-phase CECT confirming hepatic vein non-visualization and partial IVC thrombus
- Large esophageal varices with portal hypertensive gastropathy on OGD
- Successful recovery with early anticoagulation (enoxaparin), diuretics, and reinstitution of thyroxine
The takeaway:
BCS should be actively considered in young patients with unexplained ascites and hepatomegaly and deranged LFTs.
Thyroid dysfunction – especially poorly controlled – deserves a place in the BCS thrombophilia workup.
Thank you to Vithya T and Praveen H. R. for their mentorship and collaboration, and to the Department of Pharmacy Practice, Al-Ameen College of Pharmacy, Bengaluru.”
Title: Budd-Chiari Syndrome Associated with Untreated Hypothyroidism in a Young Female: A Clinical Case Report
Authors: Rahul Saha, Vithya T, Praveen H. R.

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