Skip to main content

Prothrombotic abnormalities in inflammatory bowel disease

Digestive Diseases and Sciences volume 34, pages 1089–1093 (1989)Cite this article

Abstract

Inflammatory bowel disease (IBD) is known to be associated with a thrombotic tendency, which is often attributed to thrombocytosis, elevated fibrinogen, or decreased antithrombin III. We prospectively studied eight patients with IBD, seven of whom had little or no disease activity, to determine if they had any laboratory abnormality known to be associated with an increased risk of thrombosis. Abnormalities in fibrinolysis were noted in five patients: four with high plasminogen activator inhibitor levels and one with poor release of tissue plasminogen activator following venous occlusion. Circulating immune complexes were present in the sera of five patients. Fibrinogen was mildly elevated in one patient, and two patients had mild thrombocytosis. Decreased levels of antithrombin III, protein C, or protein S were not observed. There appears to be a high incidence of abnormalities in fibrinolysis in inactive IBD, which may contribute to the high frequency of thrombosis seen in IBD. The presence of circulating immune complexes may contribute to vascular injury and thrombosis.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Bargen JA, Barker NW: Extensive arterial and venous thrombosis complicating chronic ulcerative colitis. Arch Intern Med 58:17–31, 1936

    Google Scholar 

  2. Talbot RW, Heppell J, Dozois RR, Beart RW: Vascular complications of inflammatory bowel disease. Mayo Clin Proc 61:140–145, 1986

    PubMed  Google Scholar 

  3. Edwards FC, Truelove SC: The course and prognosis of ulcerative colitis. III. Complications. Gut 5:1–15, 1964

    Google Scholar 

  4. Graef V, Baggenstoss AH, Sauer WG, Spittell JA: Venous thrombosis occurring with non-specific ulcerative colitis. Arch Intern Med 117:277–282, 1966

    Google Scholar 

  5. Koenigs KP, McPhedran P, Spiro HM: Thrombosis in inflammatory bowel disease. J Clin Gastroenterol 9:627–631, 1987

    PubMed  Google Scholar 

  6. Lam A, Borda IT, Inwood MJ, Thomson S: Coagulation studies in ulcerative colitis and Crohn's disease. Gastroenterol 68:245–251, 1975

    PubMed  Google Scholar 

  7. Lee JCL, Spittell JA, Sauer WG, Owen CA, Thompson JH: Hypercoagulability associated with chronic ulcerative colitis. Changes in blood coagulation factors. Gastroenterology 54:76–84, 1968

    PubMed  Google Scholar 

  8. Lake AM, Stauffer JQ, Stuart MJ: Hemostatic alterations in inflammatory bowel disease. Response to therapy. Am J Dig Dis 23:897–902, 1978

    PubMed  Google Scholar 

  9. Knot EAR, Ten Cate JW, Leeksma OCH, Tytgat GN, Vreeken J: No evidence for a prethrombotic state in stable chronic inflammatory bowel disease. J Clin Pathol 36:1387–1390, 1983

    PubMed  Google Scholar 

  10. Morowitz DA, Allen LW, Kirnsner JB: Thrombocytosis in chronic inflammatory bowel disease. Ann Intern Med 68:1013–1021, 1966

    Google Scholar 

  11. Talstead I, Rootweit K, Gijone E: Thrombocytosis in ulcerative colitis and Crohn's disease. Scand J Gastroenterol 8:135–138, 1970

    Google Scholar 

  12. Ghosh S, Mackie MJ, McVerry BA, Galloway M, Ellis A, McKay J: Chronic inflammatory bowel disease, deepvenous thrombosis and antithrombin activity. Acta Haematol 70:50–53, 1983

    PubMed  Google Scholar 

  13. Knot EAR, Ten Cate JW, Bruin T, Iburg AHC, Tytgat GNJ: Antithrombin III metabolism in two colitis patients with acquired antithrombin III deficiency. Gastroenterology 89:421–425, 1985

    PubMed  Google Scholar 

  14. National Diabetes Data Group: Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28:1039–1057, 1979

    Google Scholar 

  15. Bertina RM, Broekmans AW, Van der Linden IK, Mertens K: Protein C deficiency in a Dutch family with thrombotic disease. Thromb Haemost 48:1–5, 1982

    PubMed  Google Scholar 

  16. Robertson BR, Pandolfi M, Nilsson IM: “Fibrinolytic capacity” in healthy volunteers estimated from effect of venous occlusion of arms. Acta Chir Scand 138:429–436, 1972

    PubMed  Google Scholar 

  17. Wiman B, Mellbring G, Ranby M: Plasminogen activator release during venous stasis and exercise as determined by a new specific assay. Clin Chem Acta 127:279–288, 1983

    Google Scholar 

  18. Nicoloso G, Hauert J, Kruithof EKO, Van Melle G, Bachmann F: Fibrinolysis in normal subjects: Comparison between plasminogen activator inhibitor and other components of the fibrinolytic system. Thromb Haemost 59:299–308, 1988

    PubMed  Google Scholar 

  19. Kowalski E, Kopec M, Niewiarowski J: An evaluation of the euglobulin method for the determination of fibrinolysis. J Clin Pathol 12:215–218, 1959

    PubMed  Google Scholar 

  20. Disis ML, McDonald RL, Colombo JL, Kobayashi RH, Angle CR, Murray S: Circulating immune complexes in cystic fibrosis and their correlation to clinical parameters. Pediatr Res 20:385–390, 1986

    PubMed  Google Scholar 

  21. Schafer AI: The hypercoagulable states. Ann Intern Med 102:814–828, 1985

    PubMed  Google Scholar 

  22. Kitchens CS: Concepts of hypercoagulability: A review of its development, clinical application, and recent progress. Semin Thromb Hemost 11:293–315, 1985

    PubMed  Google Scholar 

  23. Hirsh J: Hypercoagulability. Semin Hematol 14:409–425, 1977

    PubMed  Google Scholar 

  24. Nilsson IM, Ljungner H, Tengborn L: Two different mechanisms in patients with venous thrombosis and defective fibrinolysis: Low concentration of plasminogen activator or increased concentration of plasminogen activator inhibitor. Br Med J 290:1453–1456, 1985

    Google Scholar 

  25. Wiman B, Ljungberg B, Chmielewska J, Urden G, Blomback M, Johnsson H: The role of the fibrinolytic system in deep vein thrombosis. J Lab Clin Med 105:265–270, 1985

    PubMed  Google Scholar 

  26. Hamsten A, Wiman B, DeFaire U, Blomback M: Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 313:1557–1563, 1985

    PubMed  Google Scholar 

  27. Allen RA, Kluft C, Brommer EJP: Effect of chronic smoking on fibrinolysis. Arteriosclerosis 5:442–450, 1985

    Google Scholar 

  28. Kjaeldgaard A, Larsson B: Long-term treatment with combined oral contraceptives and cigarette smoking associated with impaired activity of tissue plasminogen activator. Acta Obstet Gynecol Scand 65:219–223, 1986

    PubMed  Google Scholar 

  29. Vague P, Juhan-Vague I, Aillaud MF, Badier C, Viard R, Alessi MC, Collen D: Correlation between blood fibrinolytic activity, plasminogen activator inhibitor level, plasma insulin level, and relative body weight in normal and obese subjects. Metabolism 35:250–253, 1986

    PubMed  Google Scholar 

  30. Hashimoto Y, Kobayashi A, Yamazaki N, Sugawara Y, Takada Y, Takada A: Relationship between age and plasma T-PA, PA-inhibitor, and PA activity. Thromb Res 46:625–633, 1987

    PubMed  Google Scholar 

  31. Kluft C, Verheijen JH, Jie AFH, Rijken DC, Preston FE, Sue-Ling HM, Jespersen J, Aasen AO: The postoperative fibrinolytic shutdown: A rapidly reverting acute phase pattern for the fast-acting inhibitor of tissue-type plasminogen activator after trauma. Scand J Clin Lab Invest 45:605–610, 1985

    PubMed  Google Scholar 

  32. Paramo JA, Alfaro MJ, Rocha E: Postoperative changes in the plasmatic levels of tissue-type plasminogen activator and its fast acting inhibitor, relationship to deep vein thrombosis and influence of prophylaxis. Thromb Haemost 54:713–716, 1985

    PubMed  Google Scholar 

  33. Vermylen J, Blackmans D, Spitz B, Deckmyn H: Thrombosis and immune disorders. Clin Haematol 15:393–412, 1986

    PubMed  Google Scholar 

  34. Lawley TJ, James SP, Jones EA: Circulating immune complexes: Their detection and potential significance in some hepatobiliary and intestinal diseases. Gastroenterology 78:626–641, 1980

    PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Sections of Oncology/Hematology and Gastroenterology, Department of Internal Medicine, University of Nebraska Medical Center, 68105-1065, Omaha, Nebraska

    Maureen G. Conlan MD, William D. Haire MD & David A. Burnett MD

Authors
  1. Maureen G. Conlan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William D. Haire MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David A. Burnett MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Support for this project was provided by the Clinical Research Unit of the University of Nebraska Medical Center.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Conlan, M.G., Haire, W.D. & Burnett, D.A. Prothrombotic abnormalities in inflammatory bowel disease. Digest Dis Sci 34, 1089–1093 (1989). https://doi.org/10.1007/BF01536380

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01536380

Key words

  • inflammatory bowel disease
  • ulcerative colitis
  • thrombosis
  • coagulation
  • fibrinolysis
  • circulating immune complexes