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Onset of Thrombin Generation Occurs More Rapidly in Pediatric Patients With Celiac Disease

Andrea Deutschmann1, Axel Schlagenhauf, Bettina Leschnik

  • 1Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.

Journal of Pediatric Gastroenterology and Nutrition
|March 21, 2015
PubMed

Insights

Pediatric celiac disease (CD) patients exhibit faster thrombin generation, indicating hypercoagulability, before dietary changes. This rapid onset of coagulation may explain the increased risk of venous thromboembolism (VTE) and stroke in untreated CD.

Area of Science:

  • Pediatric Gastroenterology
  • Hematology
  • Immunology

Background:

  • Celiac disease (CD) is linked to increased risk of venous thromboembolism (VTE) and stroke.
  • Mechanisms underlying this association remain unclear.
  • Thrombin generation assessment offers a method to detect hypercoagulable states.

Purpose of the Study:

  • To investigate thrombin generation in pediatric patients with celiac disease.
  • To compare thrombin generation in celiac patients with healthy pediatric controls.
  • To assess changes in thrombin generation following a gluten-free diet.

Main Methods:

  • Calibrated automated thrombography was used to measure thrombin generation in plasma.
  • Samples were collected from 19 pediatric celiac disease patients and 20 healthy controls.
  • Measurements were taken at diagnosis and after gluten-free diet normalization in CD patients.

Main Results:

  • Untreated celiac patients showed significantly shorter lag time and time-to-peak for thrombin generation compared to controls.
  • These hypercoagulable changes resolved after normalization of IgA antitissue transglutaminase antibody (tTG-Ab) titers.
  • Endogenous thrombin potential (ETP), a key thromboembolic predictor, was not significantly different between groups.

Conclusions:

  • Alterations in coagulation, specifically faster thrombin generation, are present in untreated pediatric celiac disease.
  • These findings may elucidate the increased risk of VTE and stroke in this population.
  • While lag time indicates hypercoagulability, ETP remained unchanged, suggesting complex coagulation dynamics.
Abstract

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