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Thrombotic Risk and Hemostatic Profiles in Pediatric Inflammatory Bowel Disease: Association with Disease Activity
Insights
Pediatric inflammatory bowel disease (IBD) shows links between inflammation and clotting factors, particularly in ulcerative colitis (UC). Platelet count, D-dimer, and Factor VIII may help monitor thrombotic risk in children with IBD.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Thrombosis Research
Background:
- Inflammatory bowel disease (IBD) is known to increase thromboembolic risk.
- Evidence regarding this risk in pediatric populations is limited.
- This study investigates coagulation markers, inflammation, and disease activity in pediatric IBD.
Purpose of the Study:
- To evaluate associations between coagulation markers, systemic inflammation, and disease activity in pediatric IBD patients.
- To assess the prevalence of silent thrombosis in this cohort.
- To identify potential biomarkers for thrombotic risk monitoring.
Main Methods:
- A cross-sectional study of 46 pediatric IBD patients.
- Doppler ultrasonography of lower extremities and portal venous system.
- Laboratory evaluation of hemostatic and inflammatory markers, analyzed against disease activity.
Main Results:
- One asymptomatic thrombus was found in a patient with Crohn's disease (CD).
- Factor VIII levels were significantly higher in ulcerative colitis (UC) than CD.
- In UC, platelet count and D-dimer correlated with disease activity and extent.
- Fibrinogen and Factor VIII correlated with disease activity scores in CD.
- Corticosteroid use was associated with higher Factor VII.
Conclusions:
- Asymptomatic thrombosis is rare in pediatric IBD.
- Inflammation and procoagulant activity are closely linked, especially in UC.
- Platelet count, D-dimer, and Factor VIII show potential as biomarkers for thrombotic risk and monitoring in pediatric IBD.
Background/Aims:
Inflammatory bowel disease (IBD) increases thromboembolic risk, but pediatric evidence remains limited. The current study evaluated the associations between coagulation markers, systemic inflammation, and disease activity in pediatric IBD and assessed the prevalence of silent thrombosis.
Materials And Methods:
A total of 46 pediatric patients with IBD were enrolled in this single center cross-sectional study. All underwent Doppler ultrasonography of the lower extremities and the portal venous system. Hemostatic and inflammatory markers were evaluated in the laboratory and were analyzed in relation to disease activity.
Results:
One asymptomatic thrombus was detected in a patient with Crohn's disease (CD). Factor VIII was significantly higher in ulcerative colitis (UC) compared to CD (median 109.5 vs. 74.3 IU/dL, P = .007). In UC, platelet count and D-dimer increased with increasing disease activity and extent. There was a significant relationship between platelet counts and the endoscopic extent (P = .008) and Mayo Score (P = .031). In CD, fibrinogen and factor VIII levels revealed a positive correlation with Pediatric Crohn's Disease Activity Index scores (P = .012 and P = .040, respectively) but not with the Simple Endoscopic Score. Corticosteroid use was linked to higher factor VII (P = .017).
Conclusion:
Asymptomatic thrombosis rare in IBD, but inflammation and procoagulant activity were closely related, especially in UC. Platelet count, D-dimer, and factor VIII might serve as biomarkers for thrombotic risk and monitoring.
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