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Prothrombotic state and signs of endothelial lesion in plasma of patients with inflammatory bowel disease

Digestive Diseases and Sciences volume 40, pages 1883–1889 (1995)Cite this article

Abstract

Recent investigations suggest that microthrombi formation in bowel capillaries could be a determinant factor in inflammatory bowel disease (IBD) pathogenesis. To evaluate the implication of the hemostatic system during these thrombotic events, we analyzed plasmatic values of prothrombotic state markers, physiologic inhibitors of coagulation, and endothelial lesion markers in 112 IBD patients. We found an increase in thrombin-antithrombin complexes and a decrease in antithrombin III, probably due to consumption, demonstrating an increase in thrombin generation. High levels ofd-dimer reflect increased fibrin formation, but there is no correlation between thrombin generation markers andd-dimer, possibly suggesting the presence of inadequate fibrinolysis. Levels of tissue factor pathway inhibitor were higher in patients than in controls. Nine patients with Crohn's disease (35% of our sample) had levels of this marker under 70% (range 37–69%). Von Willebrand factor values were increased and those of thrombomodulin only in active patients. Most of the changes were detected in patients with inflammatory activity, and there were no differences between ulcerative colitis and Crohn's disease. In conclusion, these results support the hypothesis that there is an endothelial lesion with sustained coagulation activation in IBD patients.

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Affiliations

  1. Unit of Hemostasis and Thrombosis, and Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Avda Pare Claret, 167, 08025, Barcelona, Spain

    Joan Carles Souto MD, Elisabet Martínez BSc, Martí Roca PhD, José Mateo MD, Joan Pujol MD, Dolors González MD & Jordi Fontcuberta PhD

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  1. Joan Carles Souto MD
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  2. Elisabet Martínez BSc
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  3. Martí Roca PhD
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  4. José Mateo MD
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  5. Joan Pujol MD
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  6. Dolors González MD
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  7. Jordi Fontcuberta PhD
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Souto, J.C., Martínez, E., Roca, M. et al. Prothrombotic state and signs of endothelial lesion in plasma of patients with inflammatory bowel disease. Digest Dis Sci 40, 1883–1889 (1995). https://doi.org/10.1007/BF02208650

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  • DOI: https://doi.org/10.1007/BF02208650

Key Words

  • d-dimer
  • inflammatory bowel disease
  • thrombin-antithrombin complexes
  • thrombomodulin
  • tissue factor pathway inhibitor
  • von Willebrand factor