Budd-Chiari syndrome

disease
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Also known as BDCHSBudd-Chiari syndrome, somaticmembranous obstruction of the inferior vena cava

Summary

Budd-Chiari syndrome (MONDO:0010947) is a disease with 3 cohort genes and 6 clinical trials.

At a glance

  • Prevalence: 1-9 / 100 000 (Worldwide) [Orphanet-validated]
  • Cohort genes: 3
  • ClinVar variants: 227
  • Phenotypes (HPO): 23
  • Clinical trials: 6

Clinical features

Epidemiology

Prevalence records

12 prevalence record(s), Orphanet:

TypeClassValueGeographyValidation
Annual incidence1-9 / 1 000 0000.1WorldwideValidated
Point prevalence1-9 / 100 0001.1WorldwideValidated
Point prevalence1-9 / 100 0001.5EuropeValidated
Annual incidence<1 / 1 000 0000.08SwedenValidated
Annual incidence<1 / 1 000 0000.05DenmarkValidated
Annual incidence<1 / 1 000 0000.02JapanValidated
Annual incidence<1 / 1 000 0000.04FranceValidated
Annual incidence1-9 / 1 000 0000.21ItalyValidated
Annual incidence<1 / 1 000 0000.087Korea, Republic ofValidated
Point prevalence1-9 / 1 000 0000.14SwedenValidated
Point prevalence1-9 / 1 000 0000.24JapanValidated
Point prevalence1-9 / 1 000 0000.529Korea, Republic ofValidated

Signs & symptoms

Clinical features (HPO)

23 HPO clinical features (Orphanet curated; top 23 by frequency):

HPO IDTermFrequency
HP:0001409Portal hypertensionVery frequent (80-99%)
HP:0001541AscitesVery frequent (80-99%)
HP:0001744SplenomegalyVery frequent (80-99%)
HP:0001394CirrhosisFrequent (30-79%)
HP:0001945FeverFrequent (30-79%)
HP:0002027Abdominal painFrequent (30-79%)
HP:0002040Esophageal varixFrequent (30-79%)
HP:0002240HepatomegalyFrequent (30-79%)
HP:0002910Elevated circulating hepatic transaminase concentrationFrequent (30-79%)
HP:0003155Elevated circulating alkaline phosphatase concentrationFrequent (30-79%)
HP:0030243Hepatic vein thrombosisFrequent (30-79%)
HP:0033045Bipedal edemaFrequent (30-79%)
HP:0000083Renal insufficiencyOccasional (5-29%)
HP:0000952JaundiceOccasional (5-29%)
HP:0001082CholecystitisOccasional (5-29%)
HP:0001824Weight lossOccasional (5-29%)
HP:0002024MalabsorptionOccasional (5-29%)
HP:0002239Gastrointestinal hemorrhageOccasional (5-29%)
HP:0002480Hepatic encephalopathyOccasional (5-29%)
HP:0002586PeritonitisOccasional (5-29%)
HP:0005214Intestinal obstructionOccasional (5-29%)
HP:0005244Gastrointestinal infarctionsOccasional (5-29%)
HP:0006554Acute hepatic failureOccasional (5-29%)

Identifiers

Disease identifiers

FieldValue
Canonical nameBudd-Chiari syndrome
Mondo IDMONDO:0010947
MeSHD006502
OMIM600880
Orphanet131
ICD-10-CMI82.0
ICD-111300118676
SNOMED CT82385007
UMLSC0856761
MedGen163632
GARD0005968
MedDRA10006537
Is cancer (heuristic)no

Also known as: BDCHS · Budd-Chiari syndrome · Budd-Chiari syndrome, somatic · membranous obstruction of the inferior vena cava

Data availability: 227 ClinVar variants.

Disease family

Classification path: disease › human disease › disease by body system or component › digestive system disorderhepatobiliary disorderliver disorderhepatic vascular disorderBudd-Chiari syndrome

Related subtypes (10): portal vein thrombosis, hepatic infarction, nutmeg liver, liver angiosarcoma, peliosis hepatis, portal hypertension, hepatic vein thrombosis, hepatic veno-occlusive disease, portosinusoidal vascular disease, Fontan-associated liver disease

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

227 retrieved; paginated sample, class counts are floors:

87 uncertain significance, 71 conflicting classifications of pathogenicity, 45 benign/likely benign, 8 benign, 6 likely pathogenic, 4 pathogenic/likely pathogenic, 3 likely benign, 2 pathogenic, 1 drug response

ClinVarVariant (HGVS)GeneClassificationReview
2734021NM_000130.5(F5):c.3088C>T (p.Arg1030Ter)F5Pathogeniccriteria provided, multiple submitters, no conflicts
2866617NM_000130.5(F5):c.5453del (p.Leu1818fs)F5Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
2895285NM_000130.5(F5):c.2021del (p.Lys674fs)F5Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
430053NM_000130.5(F5):c.5037dup (p.Ser1680fs)F5Pathogeniccriteria provided, multiple submitters, no conflicts
627264NM_000130.5(F5):c.1830_1831dup (p.His611fs)F5Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
14662NM_004972.4(JAK2):c.1849G>T (p.Val617Phe)INSL6Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
2887062NM_000130.5(F5):c.4962_4971+3delF5Likely pathogeniccriteria provided, multiple submitters, no conflicts
3600169NM_000130.5(F5):c.5816T>G (p.Leu1939Ter)F5Likely pathogeniccriteria provided, single submitter
3600193NM_000130.5(F5):c.2846del (p.Leu949fs)F5Likely pathogeniccriteria provided, single submitter
3600196NM_000130.5(F5):c.2079T>G (p.Tyr693Ter)F5Likely pathogeniccriteria provided, single submitter
3600213NM_000130.5(F5):c.1297-1G>CF5Likely pathogeniccriteria provided, single submitter
3600215NM_000130.5(F5):c.1059del (p.Phe353fs)F5Likely pathogeniccriteria provided, single submitter
642NM_000130.4(F5):c.1601G>A (p.Arg534Gln)F5drug responsereviewed by expert panel
1771009NM_000130.5(F5):c.136C>G (p.Arg46Gly)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
255209NM_000130.5(F5):c.5177G>A (p.Arg1726Gln)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293550NM_000130.5(F5):c.*1290G>AF5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293557NM_000130.5(F5):c.*838T>CF5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293560NM_000130.5(F5):c.*581C>AF5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293574NM_000130.5(F5):c.6360G>A (p.Lys2120=)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293575NM_000130.5(F5):c.6309G>A (p.Leu2103=)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293577NM_000130.5(F5):c.5788+4A>TF5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293578NM_000130.5(F5):c.5721T>C (p.Cys1907=)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293579NM_000130.5(F5):c.5589C>A (p.Pro1863=)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293582NM_000130.5(F5):c.5490G>A (p.Leu1830=)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293585NM_000130.5(F5):c.5419+11C>GF5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293589NM_000130.5(F5):c.5124C>T (p.Tyr1708=)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293590NM_000130.5(F5):c.5054C>G (p.Thr1685Ser)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293592NM_000130.5(F5):c.4972-14A>CF5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293594NM_000130.5(F5):c.4835A>T (p.Asp1612Val)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications
293595NM_000130.5(F5):c.4405T>C (p.Ser1469Pro)F5Conflicting classifications of pathogenicitycriteria provided, conflicting classifications

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 0 · Orphanet: 12 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
F5Orphanet:131Budd-Chiari syndrome
F5Orphanet:326Congenital factor V deficiency
F5Orphanet:329217Cerebral sinovenous thrombosis
F5Orphanet:391320East Texas bleeding disorder
F5Orphanet:599579Factor V Amsterdam bleeding disorder
F5Orphanet:600194Factor V Atlanta bleeding disorder
JAK2Orphanet:131Budd-Chiari syndrome
JAK2Orphanet:3318Essential thrombocythemia
JAK2Orphanet:667662Breast implant-associated anaplastic large cell lymphoma
JAK2Orphanet:71493Familial thrombocytosis
JAK2Orphanet:729Polycythemia vera
JAK2Orphanet:824Primary myelofibrosis

Cohort genes → proteins

3 cohort genes, 3 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence3

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
F5HGNC:3542ENSG00000198734P12259Coagulation factor Vclinvar
INSL6HGNC:6089ENSG00000120210Q9Y581Insulin-like peptide INSL6clinvar
JAK2HGNC:6192ENSG00000096968O60674Tyrosine-protein kinase JAK2clinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
F5Coagulation factor VCentral regulator of hemostasis.
INSL6Insulin-like peptide INSL6May have a role in sperm development and fertilization.
JAK2Tyrosine-protein kinase JAK2Non-receptor tyrosine kinase involved in various processes such as cell growth, development, differentiation or histone modifications.

Protein-family classification

Druggable: 1 · Difficult: 0 · Unknown: 2 · Druggable fraction: 0.33

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Kinase19.2×0.209
Other/Unknown21.2×0.587

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
F5Other/UnknownnoFA58C, Cupredoxin, Galactose-bd-like_sf
INSL6Other/UnknownnoInsulin-like, Insulin-like_pep_6, Insulin_CS
JAK2Kinaseyes2.7.10.2FERM_domain, Prot_kinase_dom, SH2

Expression context

Cohort genes with no expression data: 0.

3 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)3
unknown0

Top tissues across cohort

TissueCohort genes
choroid plexus epithelium1
liver1
right lobe of liver1
left testis1
male germ line stem cell (sensu Vertebrata) in testis1
right testis1
blood vessel layer1
calcaneal tendon1
monocyte1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
F5206broadmarkerright lobe of liver, liver, choroid plexus epithelium
INSL6152tissue_specificmarkermale germ line stem cell (sensu Vertebrata) in testis, left testis, right testis
JAK2272ubiquitousmarkercalcaneal tendon, monocyte, blood vessel layer

Protein interactions among cohort

Intra-cohort edges: 0.

Hub genes (top 10 by interactor count)

SymbolInteractor count
JAK26,197
F51,754
INSL6509

Structural data

PDB: 2 · AlphaFold-only: 1 · No structure: 0

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
JAK2O60674164
F5P1225918

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
INSL6Q9Y58154.46

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 76. Enrichment computed across 3 evidence-associated genes (2 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Defective cleavage of FV variant at a.a.53411903.3×0.010F5
Defective cleavage of FV variant at R33411903.3×0.010F5
Erythropoietin activates Phospholipase C gamma (PLCG)1815.7×0.010JAK2
Erythropoietin activates STAT51815.7×0.010JAK2
Interleukin-6 family signaling1713.8×0.010JAK2
IFNG signaling activates MAPKs1713.8×0.010JAK2
Interleukin-23 signaling1634.4×0.010JAK2
MAPK1 (ERK2) activation1571.0×0.010JAK2
Signaling by KIT in disease1571.0×0.010JAK2
MAPK3 (ERK1) activation1519.1×0.010JAK2
Signaling by Leptin1519.1×0.010JAK2
Signaling by Erythropoietin1519.1×0.010JAK2
Interleukin-27 signaling1519.1×0.010JAK2
Interleukin-6 signaling1475.8×0.010JAK2
Interleukin-35 Signalling1475.8×0.010JAK2
Erythropoietin activates Phosphoinositide-3-kinase (PI3K)1475.8×0.010JAK2
Regulation of IFNG signaling1407.9×0.010JAK2
Prolactin receptor signaling1380.7×0.010JAK2
Erythropoietin activates RAS1380.7×0.010JAK2
RAF-independent MAPK1/3 activation1317.2×0.010JAK2
Interleukin-2 family signaling1317.2×0.010JAK2
IL-6-type cytokine receptor ligand interactions1317.2×0.010JAK2
Amplification and propagation of coagulation cascade1317.2×0.010F5
Signaling by CSF3 (G-CSF)1285.5×0.011JAK2
Signaling by phosphorylated juxtamembrane, extracellular and kinase domain KIT mutants1259.6×0.011JAK2
Interleukin-12 family signaling1237.9×0.011JAK2
Initiation of coagulation cascade1237.9×0.011F5
Growth hormone receptor signaling1237.9×0.011JAK2
Inactivation of CSF3 (G-CSF) signaling1219.6×0.011JAK2
Signaling by RAS mutants1211.5×0.011JAK2

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
nuclear receptor-mediated mineralocorticoid signaling pathway18426.0×0.004JAK2
symbiont-induced defense-related programmed cell death18426.0×0.004JAK2
interleukin-35-mediated signaling pathway18426.0×0.004JAK2
response to interleukin-1214213.0×0.004JAK2
positive regulation of growth factor dependent skeletal muscle satellite cell proliferation14213.0×0.004JAK2
regulation of postsynapse to nucleus signaling pathway14213.0×0.004JAK2
response to vitamin K12808.7×0.004F5
positive regulation of growth hormone receptor signaling pathway12808.7×0.004JAK2
collagen-activated signaling pathway12106.5×0.004JAK2
granulocyte-macrophage colony-stimulating factor signaling pathway12106.5×0.004JAK2
activation of Janus kinase activity12106.5×0.004JAK2
post-embryonic hemopoiesis11404.3×0.004JAK2
cellular response to interleukin-311404.3×0.004JAK2
interleukin-5-mediated signaling pathway11404.3×0.004JAK2
interleukin-23-mediated signaling pathway11404.3×0.004JAK2
erythropoietin-mediated signaling pathway11404.3×0.004JAK2
positive regulation of NK T cell proliferation11404.3×0.004JAK2
positive regulation of leukocyte proliferation11404.3×0.004JAK2
interleukin-3-mediated signaling pathway11203.7×0.004JAK2
thrombopoietin-mediated signaling pathway11053.2×0.004JAK2
interleukin-12-mediated signaling pathway1936.2×0.004JAK2
mammary gland epithelium development1936.2×0.004JAK2
response to hydroperoxide1842.6×0.004JAK2
regulation of nitric oxide biosynthetic process1842.6×0.004JAK2
growth hormone receptor signaling pathway via JAK-STAT1766.0×0.004JAK2
negative regulation of protein localization to chromatin1766.0×0.004JAK2
positive regulation of natural killer cell proliferation1702.2×0.004JAK2
regulation of receptor signaling pathway via JAK-STAT1702.2×0.004JAK2
positive regulation of T-helper 17 type immune response1702.2×0.004JAK2
enzyme-linked receptor protein signaling pathway1648.1×0.004JAK2

Therapeutics

Drug target analysis

Approved (phase 4): 2 · Phase ≥3: 2 · Phased (≥1): 2 · Undrugged: 1

Druggability breadth: 2 of 3 evidence-associated genes (67%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Genes with an approved drug

The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.

SymbolExample approved molecule
F5EDOXABAN
JAK2FEDRATINIB

Top cohort targets by molecule count

SymbolMoleculesMax phase
JAK21004
F524
INSL600

Drugs targeting cohort genes (top 30)

MoleculeMax phaseTargets in cohort
EDOXABAN4F5
FEDRATINIB4JAK2
RUXOLITINIB4JAK2
TOFACITINIB4JAK2
UPADACITINIB4JAK2
MOMELOTINIB4JAK2
PONATINIB4JAK2
AXITINIB4JAK2
NICLOSAMIDE4JAK2
RUXOLITINIB PHOSPHATE4JAK2
INFIGRATINIB PHOSPHATE4JAK2
INFIGRATINIB4JAK2
ENTRECTINIB4JAK2
DABRAFENIB4JAK2
PACRITINIB4JAK2
TOFACITINIB CITRATE4JAK2
BARICITINIB4JAK2
CERITINIB4JAK2
BOSUTINIB4JAK2
PEFICITINIB4JAK2
LORLATINIB4JAK2
FILGOTINIB4JAK2
BRIGATINIB4JAK2
ABROCITINIB4JAK2
REPOTRECTINIB4JAK2
DEUCRAVACITINIB4JAK2
PRALSETINIB4JAK2
CRAVACITINIB4JAK2
PAZOPANIB4JAK2
NINTEDANIB4JAK2

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 1.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
JAK22,018Binding:1911, Functional:51, ADMET:48, Unclassified:4, Toxicity:4
F510Binding:10

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
JAK22.7.10.2non-specific protein-tyrosine kinase

Cohort genes with high screening signal

≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.

SymbolChEMBL assays
JAK22,018

Pharmacogenomics

Cohort genes with a PharmGKB record: 3; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

30 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

CompoundMax phaseCohort target (bioactivity)
EDOXABAN4F5
FEDRATINIB4JAK2
RUXOLITINIB4JAK2
TOFACITINIB4JAK2
UPADACITINIB4JAK2
MOMELOTINIB4JAK2
PONATINIB4JAK2
AXITINIB4JAK2
NICLOSAMIDE4JAK2
RUXOLITINIB PHOSPHATE4JAK2
INFIGRATINIB PHOSPHATE4JAK2
INFIGRATINIB4JAK2
ENTRECTINIB4JAK2
DABRAFENIB4JAK2
PACRITINIB4JAK2
TOFACITINIB CITRATE4JAK2
BARICITINIB4JAK2
CERITINIB4JAK2
BOSUTINIB4JAK2
PEFICITINIB4JAK2
LORLATINIB4JAK2
FILGOTINIB4JAK2
BRIGATINIB4JAK2
ABROCITINIB4JAK2
REPOTRECTINIB4JAK2
DEUCRAVACITINIB4JAK2
PRALSETINIB4JAK2
CRAVACITINIB4JAK2
PAZOPANIB4JAK2
NINTEDANIB4JAK2

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)2F5, JAK2
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug0
DDruggable family + AlphaFold only, no drug0
EDifficult family or no structure, no drug1INSL6

Undrugged target profiles

1 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
INSL60

Clinical trials & evidence

Clinical trials

Clinical trials: 6.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified6

Top trials by phase / activity

NCTPhaseStatusTitle
NCT05782556Not specifiedRECRUITINGFreiburg TIPS Registry
NCT06960473Not specifiedNOT_YET_RECRUITINGA Prospective Study on IVUS and DSA Guidance in the Treatment of Budd-Chiari Syndrome
NCT02201485Not specifiedCOMPLETEDBudd-Chiari Syndrome in China: Balloon Angioplasty Alone or Combined With Stent Placement?
NCT03541057Not specifiedUNKNOWNVienna Vascular Liver Disease Study
NCT05117684Not specifiedCOMPLETEDTo Compare Balloon Occluded Thrombolysis With Conventional Catheter Directed Thrombolysis in Thrombotically Occluded DIPSS Stent in Patients of Budd- Chiari Syndrome.
NCT06054451Not specifiedUNKNOWNClinical Diagnosis and Pathological Spectrum of Porto-sinusoidal Vascular Disease in India