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Changes in blood rheology caused by Crohn's disease
G Novacek1, H Vogelsang, D Genser
1Department of Internal Medicine IV, University of Vienna, Austria.
Insights
Blood rheology is altered in Crohn's disease (CD) patients, with higher fibrinogen, red cell aggregation, and plasma viscosity linked to inflammation. These changes may contribute to thromboembolism and disease pathogenesis.
Area of Science:
- Gastroenterology
- Hematology
- Immunology
Background:
- Crohn's disease (CD) patients exhibit an elevated risk of thromboembolism.
- Abnormalities in blood rheology are implicated in CD pathogenesis and thromboembolic events.
Purpose of the Study:
- To investigate and assess blood rheological parameters in patients with Crohn's disease.
Main Methods:
- A prospective study evaluated rheological parameters in 37 inactive CD patients, 31 active CD patients, and 39 controls.
- Measured parameters included fibrinogen, red cell aggregation, and plasma viscosity.
- Serum inflammatory markers (C-reactive protein, orosomucoid) were also assessed.
Main Results:
- Fibrinogen, red cell aggregation, and plasma viscosity were significantly elevated in both active and inactive CD patients compared to controls.
- Fibrinogen levels were notably higher in active CD patients than in inactive CD patients.
- Rheological parameters demonstrated a correlation with serum inflammatory markers.
Conclusions:
- Altered blood rheology in CD patients is associated with inflammatory activity.
- These rheological changes may play a role in the development of thromboembolism and mucosal inflammation in CD, particularly in cases of high inflammatory activity.
Background:
Patients with Crohn's disease (CD) are at increased risk for thromboembolism, and multifocal microvascular infarction has even been suggested as a pathogenetic mechanism in CD. Abnormalities in blood rheology may contribute to the thromboembolism.
Objectives:
To assess blood rheology in CD patients.
Design:
Prospective evaluation of rheological parameters.
Setting:
Out-patients at the gastroenterological department of a university hospital.
Patients:
Thirty-seven patients with inactive CD (Crohn's disease activity index (CDAI) < 150), 31 patients with active CD (CDAI > 150), and 39 control subjects with no CD were included in the study.
Methods:
C-reactive protein and orosomucoid were used as serum inflammatory parameters. Fibrinogen, red cell aggregation (low shear, 3/s) and plasma viscosity were used as rheological parameters.
Results:
Fibrinogen (active CD: median 530 mg/dl (interquartile range 410-630); inactive CD: 377 (316-499); and controls: 246 (220-280)), red cell aggregation (active CD: 9.97 arb. units (8.58-11.77); inactive CD: 9.03 (7.25-10.37); controls: 7.58 (7-8.52)); and plasma viscosity (active CD: 1.82 mPa.s (1.68-1.95); inactive CD: 1.72 (1.65-1.82), controls: 1.61 (1.58-1.64)) were all significantly higher in patients with active and inactive CD than they were in controls. Additionally, fibrinogen was significantly higher in patients with active CD than it was in patients with inactive CD. The rheological parameters correlated with serum inflammatory parameters.
Conclusion:
Changes in blood rheology seem to be associated with inflammatory activity in patients with CD. These changes may be involved in the development of thromboembolism and the pathogenesis of mucosal inflammation, especially in patients with high inflammatory activity.