Related Experiment Video
Updated: Jun 7, 2025
A TNBS-Induced Rodent Model to Study the Pathogenic Role of Mechanical Stress in Crohn's Disease
Published on: March 1, 2022
The Risk of Venous Thromboembolism in Children With Inflammatory Bowel Disease
Philip R Harvey1, David McNulty2, Benjamin Coupland2
1Department of Gastroenterology, Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom.
Insights
Children with inflammatory bowel disease (IBD) face a significantly higher risk of venous thromboembolism (VTE), especially around the time of diagnosis. This risk is notably greater in younger children, with cerebral venous sinus thrombosis being more prevalent.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Epidemiology
Background:
- Children with inflammatory bowel disease (IBD) exhibit an elevated risk of venous thromboembolism (VTE).
- Previous estimates of VTE risk in pediatric IBD populations have been limited and variable.
- This study aimed to establish national estimates for VTE risk in children diagnosed with IBD.
Purpose of the Study:
- To quantify the national risk of VTE in children with IBD.
- To compare VTE risk between children with and without IBD.
- To identify periods of highest VTE risk around IBD diagnosis.
Main Methods:
- Utilized Hospital Episode Statistics data from 2001-2019.
- Identified pediatric patients (<18 years) with IBD or VTE diagnoses.
- Calculated absolute and relative risks of VTE in IBD and non-IBD pediatric populations.
Main Results:
- The absolute risk of VTE in children with IBD was 9.42 per 10,000 patient-years, versus 0.18 in children without IBD.
- The highest risk period for VTE was between 6 months before and 1 year after IBD diagnosis.
- Relative VTE risk was highest in younger children (0-8 years: 96.5; 9-11 years: 153.1) compared to adolescents (15-17 years: 14.3).
- Cerebral venous sinus thrombosis (CVST) was significantly more common in pediatric IBD patients (17.6%) than in controls (4.2%).
Conclusions:
- Confirms a substantially increased VTE risk in children with IBD.
- The period surrounding IBD diagnosis represents the peak risk for VTE.
- CVST is a significantly more frequent complication in children with IBD.
Background:
Recent studies of children with inflammatory bowel disease (IBD) demonstrate an increased venous thromboembolism (VTE) risk. However, estimates of risk are variable and case numbers are limited. The aim of this study was to provide national estimates of the risk of VTE in children with IBD.
Methods:
Hospital Episode Statistics was used to identify patients diagnosed with either IBD or VTE before reaching 18 years of age between 2001 and 2019. Populations and subgroups are described, and the risks of developing VTE in the general and IBD populations were calculated.
Results:
Children with VTE following a diagnosis of IBD or in the previous 6 months (n = 85) and with VTE without IBD (n = 4160) were studied. The absolute risk in children with IBD was 9.42 (95% confidence interval [CI], 7.4-11.4) per 10 000 patient-years, compared with 0.18 (95% CI, 18-0.19) in children without IBD. Between 6 months prior to and 1 year following IBD diagnosis was the highest absolute risk period for VTE (18.0; 95% CI, 13.7-22.4). The relative risk of VTE in children with IBD vs children without IBD was greatest in younger patient groups: the relative risk for the age band 0 to 8 years was 96.5 (95% CI, 51.8-179.9) and for 9 to 11 years was 153.1 (95% CI, 81.2-288.8) vs 14.3 (95% CI, 10.3-20.0) for 15 to 17 years. Cerebral venous sinus thrombosis represented 17.6% of pediatric VTE events in IBD patients compared with 4.2% in children without IBD (P = .001).
Conclusions:
This study confirms the increased risk of VTE in children with IBD compared with children without IBD. The time of greatest VTE risk was around diagnosis. Cerebral venous sinus thrombosis was significantly more common in children with IBD than other children.
Related Concept Videos
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD: