Screening for thromboembolic risk factors on IBD patients

Background: Patients with inflammatory bowel disease (IBD) have increased risk of thromboembolic complications which represent an important cause of morbidity and mortality.

The aim of study was to assess thrombophylic alterations of our patients suffering from IBD.

Method: Acquired and inherited risk factors for thrombosis were examined on 47 consecutive patients (20 ulcerative colitis and 27 Morbus Crohn).

Results: Two of 47 patients had previous history of thrombosis. Six patients smoked, and one woman were on oral contraceptives.

Coagulation studies: Prothrombin time and INR were normal in all cases. 29/47 patients had an elevated fibrinogen level. D-dimer was detectable in 11 cases. Antithrombin III (AT III) level decreased in one case and elevated AT III levels in 11 patients. No deficiency of protein C and protein S was detected in any patients but high protein C levels were observed in 12 cases.

11/47 patients had thrombocytosis. Platelet aggregation was inhibited in 3 out of 42 cases taking 5-ASA medication.

Inherited resistance of factor V Leiden to degradation by activated protein C (APC) is a major cause for venous thrombosis. We found APC resistance in 9/47 cases. Recently lipoprotein(a) has been recognized as a risk factor for thrombosis, 18/47 cases had these abnormalities.

Conclusion: Risk factors of thromboembolic events are detectable on IBD patients. The presence of thrombophylic abnormalities may increase the risk for thrombosis of these patients therefore during immobilization, long journey, surgery, pregnancy or others thrombogenetic conditions these patients need thrombosis prophylaxis.