Background: Portal vein thrombosis in adults is usually related to cirrhosis.There are several possible therapies. including anticoagulation, transjugular intrahepatic portosystemicshunt, ballon dilatation, local and systemic fibrinolytics agents. Hypercoagulable states are also reportedin association with this disease entity. Eosinophilia may activate platelets and promote thrombosis dueto proteins contained in intracytoplasmic granules, such as eosinophil cationic protein and major basicprotein. There is only one paper in the medical literature linking eosinophilia and portal vein thrombosis.Case Report: We present here the case of a middle-age woman with idiopathic eosinophilia and acute portalvein thrombosis with massive venous thrombosis, involving the mesenteric, splenic, inferior cava, iliacand femoral veins, successfully treated with systemic streptokinase. Conclusions: Acute portal vein thrombosiswith associated mesenteric and splenic vein thrombosis is a potentially lethal coagulation disorder thatcan be treated successfully with systemic streptokinase.

Keywords: Budd-Chiari Syndrome - radiography, Eosinophilia - complications, Portal Vein - pathology, Streptokinase - therapeutic use, Thrombolytic Therapy, Tomography, X-Ray Computed