Abstrakt
Inflammatory bowel disease (IBD) can be associated with hypercoagulable disorders. Aim of our single-centre, prospective study was an in-depth evaluation of acquired hypercoagulable states in IBD patients.
A total of 110 patients with Crohn’s disease, 43 with ulcerative colitis and 30 controls were enrolled. Full blood count, serum CRP, proteins C and S, APC-resistance, thrombin-antithrombin complex (TAT), F1+F2 fragments, tissue factor pathway inhibitor (TFPI) total and truncated, TFPI-factor Xa, tissue plasminogen activator (tPA) and PAI-I antigen were investigated in peripheral blood samples.
Only 18/153 (11.8%) of IBD patients had all haemocoagulation parameters within normal range. Significant difference between IBD patients and controls was found in thrombocyte volume (p<0.001), protein C (p=0.025), protein S (p=0.003), APC-resistance (p<0.001), F1+F2 fragments (p<0.001) and tPA (p=0.002).
In CD divided into two subgroups according to serum CRP values (non-active disease: <5 mg/L; active disease ≥5 mg/L), thrombocyte count was significantly lower (p=0.001), thrombocyte volume significantly higher (p=0.002), F1+F2 fragments significantly lower (p=0.007) and tPA significantly higher (p=0.038) in the subgroup with CRP <5 mg/L. In UC, no significant difference depending on CRP was found.
Acquired hypercoagulable abnormalities in IBD patients are frequent. Patients with active CD, but not UC, displayed significantly different haemocoagulable parameters, when compared to non-active CD/UC subjects.
In patients with active CD (with increased serum CRP concentration) and patients with active extensive UC found at endoscopy (despite low CRP values) prophylactic anticoagulation therapy should be considered.