Identification of an inflammatory bowel disease patient with a deep vein thrombosis and an altered clot lysis profile

Abstract

Patients with inflammatory bowel diseases (IBD), a chronic inflammatory disease characterized by flares and remission, are prone to develop thrombosis. The mechanism behind this prothrombotic state is not completely understood but is definitely multifactorial and linked with excessive inflammation observed in these patients. So far, no biomarker exists to select among IBD patients those with and increased risk for thrombosis. Corticosteroid therapy, given as rescue IBD treatment, is known to increase the thrombotic risk, whereas for antitumor necrosis factor (TNF)-alpha therapy such as infliximab, given to induce and maintain remission in IBD, the results are inconclusive. Here, we describe a 31-year-old IBD patient who developed a deep vein thrombosis. We determined the clot lysis profiles before and after developing thrombosis. We showed that a global functional clot lysis assay can be used as a tool to identify IBD patients who may benefit from thromboprophylactic therapy.

Modelling of the relationship between infliximab exposure, faecal calprotectin and endoscopic remission in patients with Crohn's disease

“…Grey numbers indicate the number of patients in each bin predictive of treatment outcome or the magnitude of the effect after treatment with infliximab. Platelet count has previously been shownto serve as an inflammatory marker in patients with inflammatory bowel diseases 40. CRP and platelet count were weakly correlated (Pearson's r 0.29).…”

Venous thromboembolism in pediatric inflammatory bowel disease: an 11-year population-based nested case–control study in Canada

“…In the present study, the thrombophilia tests were conducted in only six VTE cases, and heterozygous factor V Leiden was determined in one patient with two VTE episodes. In future research, additional factors should include comprehensive thrombophilia testing (including a global functional clot lysis assay) [37], ethnicity, obesity, smoking, hormonal birth control methods, and medication treatment duration. Further prospective research could aid in the development of a predictive model based on risk factors, which could help identify patients who may require closer bedside assessment or additional screening investigations such as the addition of a Doppler study during routine abdominal ultrasounds commonly performed on hospitalized IBD patients.…”