Prevalence and risk factors of thromboembolic complications in inflammatory bowel disease

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Published Dec 20, 2011
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Vol. 89 No. (2011): Issue Dec 2011

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Yosra Said
Lamine Hamzaoui
Kaouther El Jeri
Radhouane Debbeche
Senda Trabelsi
Amel Moussa
Slim Bouzaidi
Mohammed Salem
Sami Guermazi
Taoufik Najjar

Abstract

Background: Patients with inflammatory bowel disease (IBD) are at increased risk of thromboembolic complications (TEC), which represent an important cause of morbidity and mortality.
Aim: To assess the prevalence and risk factors of TEC in patients with IBD.
Methods: We conducted a retrospective study including all the IBD patients in the gastroenterological department of Charles Nicolle hospital between 2000 and 2010. Only thromboembolic events that had been diagnosed by an imaging procedure were counted.
Results: A total of 266 patients with IBD were consecutively included. TE events occurred in nine patients (3.4%); six men and three women. Their mean age was 31years [15-64 years]. Five patients had Crohn’s disease and four had ulcerative colitis. The types of TEC were deep venous thrombosis of the leg in five cases
with pulmonary embolism in one of them, cerebral venous thrombosis in two cases, portal thrombosis in one case and jugular vein thrombosis in one case. Active disease was present in all cases at the time TEC occurred.
Conclusions: In our study, the prevalence of TEC is 3.4% in patients with IBD. Deep venous thromboses of the leg are the most common TEC and all our cases occurs during the active phase of IBD.

Keywords:

Inflammatory bowel disease, thrombosis

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References

  1. Bernstein CN, Blanchard JF, Houston DS, et al. The incidence ofdeep venous thrombosis and pulmonary embolism amongpatients with inflammatory bowel disease: a populationbased cohort study. Thromb Haemost 2001; 85:430-4.
  2. Miehsler W, Reinisch W, Valic E, et al. Is inflammatory boweldisease an independent and disease specific risk factor forthromboembolism? Gut 2004; 53:542-8.
  3. Bernstein CN, Nabalamba A. Hospitalization-based major comorbidity of inflammatory bowel disease in Canada. Can J Gastroenterol 2007; 21:507-11.
  4. Nguyen GC, Sam J. Rising prevalence of venous thromboembolism and its impact on mortality among hospitalizedinflammatory bowel disease patients. Am J Gastroenterol 2008;103:1-9.
  5. Talbot RW, Heppell J, Dozois RR, Beart RW. Vascular complications of inflammatory bowel disease. Mayo Clin Proc 1986; 6: 140-5.
  6. Grip O, Svensson PJ, Lindgren S. Inflammatory bowel diseasepromotes venous thrombosis earlier in life. Scand J Gastroenterol 2000; 35: 619-23.
  7. Danese S, Papa A, Saibeni S, et al. Inflammation and coagulation in inflammatory bowel disease: the clot thickens. Am J Gastroenterol 2007; 102: 174-86.
  8. Solem CA, Loftus EV, Tremaine WJ, Sandborn WJ. Venousthromboembolism in inflammatory bowel disease.Am J Gastroenterol 2004; 99: 97-101.
  9. Grainge MJ, West J, Card TR. Venous thromboembolism during active disease and remission in infl ammatory bowel disease:a cohort study. Lancet 2010; 375: 657-63.
  10. Spina L, Saibeni S, Battaglioli T, Peyvandi F, de Franchis R, Vecchi M. Thrombosis in inflammatory bowel diseases: Role of inherited thrombophilia. Am J Gastroenterol. 2005;100:2036.41.
  11. Geerts WH, Bergquist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest 2008;133:353-81.
  12. Dentali F, Douketis JD, Gianni M, et al. Meta-analysis: anticoagulant prophylaxis to prevent symtomatic venous thromboemblism in hospitalized medical patients. Ann Int Med 2007; 146: 278-88.
  13. Van Assche G, Dignass A, Reinisch W, et al. The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Special situations. J Crohns Colitis 2010; 4: 63-101.
  14. Danese S, Sans M, Fiocchi C. Inflammatory bowel disease: The role of environmental Factors. Autoimmun Rev 2004;3:394.400.
  15. Kearon C, Kahn SR, Agnelli G, et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians evidence-based clinical practice guideline (8thedition). Chest 2008; 133: 454-545.
  16. Cardiovascular Disease Educational and Research Trust, Cyprus Cardiovascular Disease Educational and Research Trust, EuropeanVenous Forum, International Surgical Thrombosis Forum,International Union of Angiology, Union Internationale de Phébologie. Prevention and treatment of venous thromboembolism. International Consensus Statement (guidelines according toscientific evidence). Int Angiol 2006; 25:101-61.
  17. Shen J, Ran ZH, Tong JL, et al. Meta-analysis: the utility and safety of heparin in the treatment of active ulcerative colitis. Aliment Pharmacol Ther 2007; 26: 653-63