Neurovascular and Thromboembolic Complications of Inflammatory Bowel Disease in Childhood

Cerebral thromboembolic events in pediatric patients with inflammatory bowel disease

“…7,8,[10][11][12][13][14][15][16][17][18][19][20][21] Although mostly anecdotal, the current evidence describes a predominance of UC (23 UC, 6 CD), similar sex distribution (male:female, 1:1.1), the majority of patients are of adolescent age rather than younger pediatric age group, and full neurological resolution of symptoms is the norm. 7,8,[10][11][12][13][14][15][16][17][18][19][20][21] In a population with a rising incidence of IBD, UC usually predominates but is then superceded by CD as IBD becomes more prevalent (this has been seen in North America and Western Europe) 4,5 ; as the majority of reported cases of CTE in pediatric IBD are from in excess of 20 years ago this may be a reflection of historical relative disease incidences. It is of interest that the other most recent pediatric case series of 4 cases 8 is the only other to report a predominance of CD, in keeping with our series.…”

“…3 Pediatric cerebral thromboembolic events (CTE) occur in 1.3-13 per 100,000 children per year in the general pediatric population 6 ; however, CTE have been described more frequently in the pediatric IBD population, between 1.4%-3.3% of patients. 7,8 The majority of the early literature described these events in UC rather than CD; however, the data on this subject are still limited. The aim of this study was to describe the incidence and outcome of CTE in a tertiary pediatric IBD clinic and to compare our results with the published literature.…”

“…7,8,[10][11][12][13][14][15][16][17][18][19][20][21] Including our 4 cases, the 15 case series were stratified into those published before 7,10,11,13-21 and after 8,12 January 1 2000. There was a statistically significant difference in the relative proportion of types of IBD being reported with this association after 2000 in that the proportion of UC had fallen while CD had risen (P ¼ 0.02) ( Table 2).…”

Neurological Manifestations of Inflammatory Bowel Disease

“…Both arterial and venous system may be afected, but deep venous thrombosis and pulmonary thromboembolism are the most common thromboembolic complications in IBD [10][11][12][13].…”

“…Nevertheless, the use of steroids, dehydration, the increase of homocysteine and infections (all of which are associated with relapsing periods) may also contribute to the development of thrombotic complications [10][11][12][13]16]. Furthermore, the presence of mutations in Leiden factor V in IBD patients leads to a higher incidence of thrombotic events [17].…”