Related Experiment Videos
Persistence of hemostatic alterations in patients affected by Crohn's disease after bowel surgery
E Chiarantini1, R Valanzano, A A Liotta
1Istituto di Clinica Medica Generale e Cardiologia, Università di Firenze, Italy.
Insights
Crohn's disease patients exhibit heightened blood clotting risks, with abnormal hemostatic parameters persisting even after surgery. Systemic inflammation, not just local factors, likely drives these thrombotic risks and disease manifestations.
Area of Science:
- Gastroenterology
- Hematology
- Immunology
Background:
- Crohn's disease (CD) is associated with hypercoagulability and increased thrombotic event risk.
- Understanding hemostatic alterations in CD is crucial for managing patient outcomes.
Purpose of the Study:
- To investigate changes in hemostatic parameters in Crohn's disease patients before and after bowel surgery.
- To compare these parameters with healthy controls and assess the influence of systemic inflammation.
Main Methods:
- Studied 31 CD patients and 30 healthy controls.
- Measured platelet number (PLT), fibrinogen (Fbg), prothrombin fragment F1+2, PAI, whole blood-spontaneous platelet aggregation (WB-SPA), and factor XIII (F XIII).
- Assessed antiphospholipid antibodies (aPL) before and at 3 and 12 months post-surgery.
Main Results:
- Pre-surgery: CD patients showed higher PLT, Fbg, F1+2, PAI, WB-SPA and lower F XIII than controls.
- Post-surgery: PLT, Fbg, WB-SPA decreased, but remained elevated compared to controls. F XIII increased.
- Antiphospholipid antibodies (aPL) increased significantly 12 months post-surgery.
Conclusions:
- Hemostatic changes in CD are influenced by systemic inflammation, not solely local factors.
- Surgery partially normalizes some clotting parameters, but risks persist.
- Systemic inflammation may contribute to both intestinal and extraintestinal CD manifestations.
Abstract:
In Crohn's disease (CD) a condition of hypercoagulability with increased risk for thrombotic events has been reported. In this study we have investigated hemostatic parameters in thirty-one patients affected by CD before, 3 and 12 months after bowel operation, and in thirty healthy controls. Before surgery platelet number (PLT), fibrinogen (Fbg), prothrombin fragment F1 + 2 (F1 + 2), PAI and whole blood-spontaneous platelet aggregation (WB-SPA) were significantly higher (p at least < 0.0005) in patients than in controls, while factor XIII (F XIII) was significantly lower (p at least < 0.005). Three and twelve months after surgery PLT, FBG and WB-SPA significantly decreased in comparison to pre-surgery values (respectively p at least < 0.05 and p < 0.01), but PLT and Fbg were still significantly higher than in controls at 3 and 12 months (p < 0.01). At three and 12 months after operation F XIII was significantly higher in comparison with pre-surgery values (p at least < 0.05). The presence of antiphospholipid antibodies (aPL) was not different between CD patients and controls before surgery, whereas it significantly increased 12 months after surgery (p < 0.05). Our results suggest that in CD hemostatic changes are only in part influenced by local flogistic processes and that an inflammatory systemic condition may provoke both the bowel and extraintestinal manifestations of CD.