The Budd-Chiari syndrome is a rare but serious condition defined as hepatic venous outflow obstruction. This article presents a case of acute Budd-Chiari syndrome in a 43-year-old woman with activated protein C resistance while she was being treated with intravenous heparin infusion for previously documented deep venous thrombosis. Activated protein C resistance caused by factor V Leiden mutation has emerged as the most prevalent hereditary cause of venous thromboembolism and should be considered as an etiologic factor in patients with Budd-Chiari syndrome.
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