Digestive Diseases and Sciences

, Volume 39, Issue 7, pp 1501–1504

Prevalence and significance of anticardiolipin antibodies in Crohn's disease

  • Patrick Chamouard
  • Lelia Grunebaum
  • Marie-Louise Wiesel
  • Jean-Marie Freyssinet
  • Bernard Duclos
  • Jean-Pierre Cazenave
  • René Baumann
Original Articles


Crohn's disease is a chronic inflammatory bowel syndrome in which thrombotic complications occur in the active phase. Phospholipid-binding antibodies such as anticardiolipin antibodies and lupus anticoagulants have been shown to be associated with thrombosis. Their presence has been assessed in a group of 50 patients with Crohn's disease among whom 44 had active disease. The overall prevalence of anticardiolipin antibodies was about 22%, while none of these patients had lupus anticoagulant. Anticardiolipin antibodies have been observed in both active and quiescent CD and their presence does not seem to be related to the site of CD lesions. The presence of phospholipid-binding antibodies could be a sign of vascular alterations that are potentially thrombogenicper se, and their predictive value with respect to the specific inflammatory syndrome of Crohn's disease is discussed.

Key words

Crohn's disease phospholipid-binding antibodies anticardiolipin antibodies thrombosis inflammation 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Chamouard P, Grunebaum L, Duclos B, Wiesel L, Cazenave JP: Manifestations biologiques d'un état préthrombotique au cours de la maldie de Crohn évolutive. Gastroenterol Clin Biol 14:203–208, 1990Google Scholar
  2. 2.
    Talbot RW, Heppell J, Dozois RR, Beart RW: Vascular complications of inflammatory bowel disease. Mayo Clin Proc 61:140–144, 1986Google Scholar
  3. 3.
    Edwards RL, Levine JB, Green R, Duffy M, Mathews E, Brande W, Rickles FR: Activation of blood coagulation in Crohn's disease: Increased plasma fibrinopeptide A levels and enhanced generation of monocyte tissue factor activity. Gastroenterology 92:329–337, 1987Google Scholar
  4. 4.
    Lake AM, Stauffer JQ, Stuart MJ: Hemostatic alterations in inflammatory bowel disease. Am J Dig Dis 23:897–902, 1978Google Scholar
  5. 5.
    Simi M, Leardi S, Tebano MT, Castelli M, Costantini FM, Speranza V: Raised plasma concentrations of platelet factor 4 (PF 4) in Crohn's disease. Gut 28:336–338, 1987Google Scholar
  6. 6.
    Conlan MG, Haire WD, Burnett DA: Prothrombotic abnormalities in inflammatory bowel disease. Dig Dis Sci 34:1089–1093, 1989Google Scholar
  7. 7.
    De Jong E, Porte RY, Knot EAR, Verheijen JH, Dees J: Disturbed fibrinolysis in patients with inflammatory bowel disease. A study in blood plasma, colon mucosa, and faeces. Gut 30:188–194, 1989Google Scholar
  8. 8.
    Grunebaum L, Kheiralla JC, Wiesel ML, Freyssinet JM, Goetz J, Imler M, Cazenave JP: Anticorps antiphospholipides (aPL): Détection et signification clinique. Rev Med Interne 4:307–314, 1992Google Scholar
  9. 9.
    McNeil HP, Chestermann CN, Krilis SA: Immunology and clinical importance of antiphospholipid antibodies. Adv Immunol 49:193–280, 1991Google Scholar
  10. 10.
    Alving BM, Barr CF, Tang DB: Correlation between lupus anticoagulants and anticardiolipin antibodies in patients with prolonged activated partial thromboplastin times. Am J Med 88:112–116, 1990Google Scholar
  11. 11.
    Love PE, Santoro SA: Anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus (SLE) and in non-SLE disorders. Ann Intern Med 112:682–698, 1990Google Scholar
  12. 12.
    Simon LS, Gorn AH: A 38-year-old woman with fever, skin lesions, thrombocytopenia, and venous thromboses. Case records of the Massachusetts General Hospital. N Engl J Med 322:754–769, 1990Google Scholar
  13. 13.
    Hess DC, Krauss J, Adam RJ, Nichols FT, Zhang DI, Rountree HA: Anticardiolipin antibodies: A study of frequency in TIA and stroke. Neurology 41:525–528, 1991Google Scholar
  14. 14.
    Levine SR, Welch KMA: Antiphospholipid antibodies. Ann Neurol 26:386–389, 1989Google Scholar
  15. 15.
    Carreras LO, Machin SJ, Deman R, Defreyn G, Vemylen J, Spitz B, Van Assche A: Arterial thrombosis, intra uterine death and lupus anticoagulant. Detection of immunoglobulin interfering with prostacyclin formation. Lancet 1:244–246, 1981Google Scholar
  16. 16.
    Francis RB, Neely S: Effect of the lupus anticoagulant on endothelial fibrinolytic activityin vitro. Thromb Haemostas 61:314–317, 1989Google Scholar
  17. 17.
    Freyssinet JM, Wiesel ML, Gauchy J, Boneu B, Cazenave JP: An IgM lupus anticoagulant that neutralizes the enhancing effect of phospholipid on purified thrombomodulin activity: A mechanism for thrombosis. Thromb Haemostas 55:309–313, 1986Google Scholar
  18. 18.
    Freyssinet JM, Gauchy J, Cazenave JP: The effect of phospholipids on the activation of protein C by the human thrombin-thrombomodulin complex. Biochem J 238:151–157, 1986Google Scholar
  19. 19.
    Lellouche F, Martinuzzo M, Said P, Maclouf J, Carreras LO: Imbalance of thromboxane/prostacyclin biosynthesis in patients with lupus anticoagulant. Blood 11:2894–2899, 1991Google Scholar
  20. 20.
    Tsakiris DA, Marbet GA, Makris PE, Settas L, Dukert F: Impaired fibrinolysis as an essential contribution to thrombosis in patients with lupus anticoagulant. Thromb Haemostas 61:175–177, 1989Google Scholar
  21. 21.
    Lennard-Jones JE: Definition and diagnosis.In Skandia International Symposia: Regional Enteritis (Crohn Disease). Nordiska Bokhandeln's Färlag, Stockholm, 1971, pp 105–112Google Scholar
  22. 22.
    Van Hees PAM, Van Elteren PH, Van Lier HJJ, Van Tongeren JHM: An index of inflammatory activity in patients with Crohn's disease. Gut 21:279–286, 1980Google Scholar
  23. 23.
    Kelsey PR, Stevenson KJ, Poller J: The diagnostic of lupus anticoagulants by the activated partial thromboplastin time. The central role of phosphatidylserine. Thromb Haemostas 52:172–175, 1984Google Scholar
  24. 24.
    Alving BM, Baldwin PE, Richards RL, Jackson BJ: The dilute phospholipid APTT: A sensitive assay for verification of lupus anticoagulant. Thromb Haemostas 54:709–712, 1985Google Scholar
  25. 25.
    Harris EN: Antiphospholipid antibodies. Br J Haematol 74:1–9, 1990Google Scholar
  26. 26.
    Wakefield AJ, Dhillon AP, Rowles PM, Sawyerr Am, Pittilo RM, Lewis AAM, Pounder RE: Pathogenesis of Crohn's disease: Multifocal gastrointestinal infarction. Lancet 2:1057–1062, 1989Google Scholar
  27. 27.
    Ligumsky M, Simon PL, Karmeli F, Rachmilewitz D: Role of interleukin 1 in inflammatory bowel disease—enhanced production during active disease. Gut 31:686–689, 1990Google Scholar
  28. 28.
    Podolsky DK. Medical progress: Inflammatory bowel disease (first of two parts). N Engl J Med 325:928–937, 1991Google Scholar
  29. 29.
    Reimund JM, Duclos B, Derlon A, Sapin R, Chamouard P, Baumann R, Weill JP: Nutritional disturbances and serum levels of tumor necrosis factor (TNF) in Crohn's disease. Gastroenterology 100:A242, 1991Google Scholar
  30. 30.
    Stevens C, Walz G, Zanker B, Singaram C, Lipman N, Strom TB: Interleukin 6 (IL-6), interleukin 1 beta (IL-1B), and tumor necrosis factor alpha (TNF α) expression in inflammatory bowel disease (IBD). Gastroenterology 98:A475, 1990Google Scholar
  31. 31.
    Dejana E, Brevario F, Erroi A, Bussolino F, Mussoni L, Gramse M, Pintucci G, Casali B, Dinarello CA, Vandamme J, Mantovani A: Modulation of endothelial cell function by different molecular species of interleukin 1. Blood 69:695–699, 1987Google Scholar
  32. 32.
    Nawroth PP, Stern DM: Modulation of endothelial cell hemostatic properties by tumor necrosis factor. J Exp Med 163:740–745, 1986Google Scholar
  33. 33.
    Pober JS: Cytokine mediated activation of the vascular endothelium. Am J Pathol 133:426–433, 1988Google Scholar
  34. 34.
    Freyssiner JM, Ravanat C, Grunebaum L, Wiesel ML, Cazenave JP: Antiphospholipid auto-antibodies in thrombosis: Cause and/or consequence of the disruption of the protein C-dependent hemostatic balance.In Phospholipid-Binding Antibodies. EN Harris, T Exner, GVR Hughes, R Asherson (eds). Boca Raton, Florida, CRC Press, 1991, pp 255–267Google Scholar
  35. 35.
    Zwaal RFA, Hemker HC: Blood cell membranes and haemostasis. Haemostasis 11:12–39, 1982Google Scholar
  36. 36.
    Bevers EM, Comfurius P, Zwaal RFA: Platelet procoagulant activity: physiological significance and mechanisms of exposure. Blood Rev 5:146–154, 1991Google Scholar
  37. 37.
    Cariou G, Tobelem G, Soria C, Caen J: Inhibition of protein C activation by endothelial cells in the presence of lupus anticoagulant. N Engl J Med 314:1193–1194, 1986Google Scholar
  38. 38.
    Wakefield AJ, Sankey EA, Dhillon AP, Sawyerr AM, More L, Sim R, Pittilo RM, Rowles PM, Hudson M, Lewis AAM, Pounder RE: Granulomatous vasculitis in Crohn's disease. Gastroenterology 100:1279–1287, 1991Google Scholar
  39. 39.
    Murch SH, Braegger CP, Sessa WC, MacDonald TT: High endothelin-1 immunoreactivity in Crohn's disease and ulcerative colitis. Lancet 1:381–385, 1992Google Scholar

Copyright information

© Plenum Publishing Corporation 1994

Authors and Affiliations

  • Patrick Chamouard
    • 1
    • 2
  • Lelia Grunebaum
    • 1
    • 2
  • Marie-Louise Wiesel
    • 1
    • 2
  • Jean-Marie Freyssinet
    • 1
    • 2
  • Bernard Duclos
    • 1
    • 2
  • Jean-Pierre Cazenave
    • 1
    • 2
  • René Baumann
    • 1
    • 2
  1. 1.From the Service d'Hépato-gastroentérologie et d'Assistance NutritiveHôpital de HautepierreStrasbourg CedexFrance
  2. 2.Service d'Hémostase et de ThromboseCentre Régional de Transfusion SanguineStrasbourg CedexFrance

Personalised recommendations