Digestive Diseases and Sciences

, Volume 46, Issue 3, pp 644–648 | Cite as

Predictive Value of Inflammatory and Coagulation Parameters in the Course of Severe Ulcerative Colitis

  • R.K. Linskens
  • A.A. Van Bodegraven
  • M. Schoorl
  • H.A.R.E. Tuynman
  • P. Bartels
Article

Abstract

Alterations in markers of coagulation have been found in patients with inflammatory bowel disease. Our aim was to study the predictive value of coagulation and inflammatory parameters in the course of severe ulcerative colitis. Twenty-seven patients were included. The disease course was followed for one year. Sensitivity, specificity, negative predictive value, positive predictive value, and likelihood ratio, as well as the clinical predictive value of laboratory variables were calculated. Inflammatory variables, such as ESR, CRP, and leukocyte and platelet count showed poor diagnostic accuracy. Several coagulation parameters, such as fibrinogen and fibrin(ogen) degradation products, were increased in patients with active ulcerative colitis, whereas coagulation factor XIII was decreased. No significant relationship between clinical course and coagulation parameters was demonstrated, though both inflammatory and coagulation parameters were useful in the assessment of disease activity in patients with active ulcerative colitis.

ulcerative colitis acute phase proteins coagulation fibrin degradation products factor XIII fibrinolysis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFRENCES

  1. 1.
    Hanauer SB: Medical therapy for ulcerative colitis. In Inflammatory Bowel Disease. JB Kirsner (ed). Philadelphia, WB Saunders, 2000, pp 529–556Google Scholar
  2. 2.
    Wedel S, Schreiber S: Laboratory tests in inflammatory bowel disease. In Inflammatory Bowel Diseases-From Bench to Bedside. T Andus, H Goebell, P Layer, J Schölmerich (eds). Dordrecht, Kluwer Academic, 1996, pp 235–241Google Scholar
  3. 3.
    Weeke B, Jarnum S: Serum concentrations of 19 serum proteins in Crohn's disease and ulcerative colitis. Gut 12:292–303, 1969Google Scholar
  4. 4.
    Buckell NA, Lennard-Jones JE, Hernandez MA, Kohn J, Riches PG, Wadsworth J: Measurements of serum proteins during attacks of ulcerative colitis as a guide to patient management. Gut 20:22–27, 1979Google Scholar
  5. 5.
    Prantera C, Davoli M, Lorenzetti R, Pallone F, Marcheggiano A, Iannoni C, Mariotti S: Clinical and laboratory indicators of extent of ulcerative colitis. J Clin Gastroenterol 10:41–45, 1988Google Scholar
  6. 6.
    Travis SPL, Farrant JM, Ricketts C, Nolan DJ, Martenson NM, Kettlewell MGW, Jewell DP: Predicting outcome in severe ulcerative colitis. Gut 38:905–910, 1996Google Scholar
  7. 7.
    Rees DC, Satsangi J, Cornelissen PL, Travis SP, White J, Jewell DP: Are serum concentrations of nitric oxide metabolites useful ifor predicting the clinical outcome of severe ulcerative colitis? Eur J Gastroenterol Hepatol7:227–230, 1995Google Scholar
  8. 8.
    van Wersch JWJ, Houben P, Rijken J: Platelet count, platelet function, coagulation activity and fibrinolysis in the acute phase of inflammatory bowel disease. J Clin Chem Clin Biochem 28:513–517, 1990Google Scholar
  9. 9.
    van Bodegraven AA, Tuynman HARE, Schoorl M, Kruishoop AM, Bartels PCM: Fibrinolytic split products, fibrinolysis, and factor XIII activity in inflammatory bowel disease. Scand J Gastroenterol 30:580–585, 1995Google Scholar
  10. 10.
    Souto JC, Martinez E, Roca M, Mateo J, Pujol J, Gonzales D, Fontcuberta J: Prothrombotic state and signs of endothelial lesions in plasma of patients with inflammatory bowel disease. Dig Dis Sci 40:1883–1889, 1995Google Scholar
  11. 11.
    Chamouard P, Grunebaum L, Wiesel M-P, Frey PL, Wittersheim C, Sapin R, Baumann R, Cazenave JP: Prothrombin fragment 1 + 2 and thrombin-antithrombin III complex as markers of activation of blood coagulation in inflammatory bowel disease. Eur J Gastroenterol Hepatol 7:1183–1188, 1995Google Scholar
  12. 12.
    van der Heide H, van der Brandt-Gradel V, Tytgat GNJ, Endert E, Wiltink EHH, Schipper MEI, Dekker W: Comparison of beclomethasone diproprionate and prednisolone 21-phosphate enemas in the treatment of ulcerative proctitis. J Clin Gastroenterol 10:169–172, 1988Google Scholar
  13. 13.
    Chambless L, McMahon R, Wu K, Folsom A, Finch A, Shen Y-L: Short-term intraindividual variability in hemostasis factors. Ann Epidemiol 2:723–733, 1992Google Scholar
  14. 14.
    Salomaa VV, Rasi V, Stengard J, Vahtera E, Pekkanen J, Vartiainen J, Ehnholm C, Puska, P: Intra-and interindividual variability of hemostatic factors and traditional cardiovascular risk factors in three-year follow-up. Thromb Haemost 79: 969–974, 1998Google Scholar
  15. 15.
    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, 1968Google Scholar
  16. 16.
    Lake AM, Stauffer JQ, Stuart MJ: Hemostatic alterations in inflammatory bowel disease. Am J Dig Dis 23:897–902, 1978Google Scholar
  17. 17.
    Lam A, Borda IT, Inwood MJ, Thompson S: Coagulation studies in ulcerative colitis and Crohn's disease. Gastroenterology 68:245–251, 1975Google Scholar
  18. 18.
    Talbot RW, Heppell J, Dozois RR, Beart RWJ: Vascular complications of inflammatory bowel disease. Mayo Clin Proc 61:140–145, 1986Google Scholar
  19. 19.
    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
  20. 20.
    Roberts HR, Tabares AH: Overview of the coagulation reactions. In Molecular Basis of Thrombosis and Hemostasis. KA High, HR Roberts (eds). New York, Marcel Dekker, 1995, pp 35–50Google Scholar
  21. 21.
    Nieuwenhuizen W: Quantitative enzyme immunoassays for degradation products of fibrinogen (FgDP), fibrin (FbDP) and total of FgDP and FbDP (TDP). In ECAT assay procedures. A manual of laboratory techniques. J Jespersen, RM Bertina, F Haverkate (eds). Dordrecht, Kluwer, 1992, pp 191–203Google Scholar
  22. 22.
    Souto JC, Martinez E, Roca M, Mateo J, Pujol J, Condomines J, et al: Low levels of plasminogen activator inhibitor type 1 in patients with inflammatory bowel disease. Fibrinolysis 8: 359–363, 1994Google Scholar
  23. 23.
    Boisclair MD, Ireland H, Lane DA: Assessment of hypercoagulable states by measurement of activation fragments and peptides. Blood Rev 4:25–40, 1990Google Scholar
  24. 24.
    Dempfle C-E, Kontny F, Abildgaard U: Predictive value of coagulation markers concerning clinical outcome 90 days after anterior myocardial infarction. Thromb Haemost 81:701–704, 1999Google Scholar
  25. 25.
    Kjeldsen J, Schaffalitzky de Muckadell OB: Assessment of disease severity and activity in inflammatory bowel disease. Scand J Gastroenterol 28:1–9, 1993Google Scholar
  26. 26.
    Fareed J, Hoppenstedt D, Bick RL, Bacher P: Drug-induced alterations of hemostasis and fibrinolysis. Hematol Oncol Clin North Am 6:1229–1245, 1992Google Scholar
  27. 27.
    Geboes K, Delabie J, Rutgeerts P, Vantrappen G: Endoscopy as a diagnostic tool in inflammatory bowel disease. Acta Chir Belg 89(2):106–110, 1989Google Scholar
  28. 28.
    Haber GB: Role of endoscopy in inflammatory bowel disease. Dig Dis Sci 32(suppl):16S–25S, 1987Google Scholar
  29. 29.
    Carbonnel F, Lavergne A, Lémann M, Bitoun A, Valleur P, Hautefeuille P, Galian A, Modigliani R, Rambaud J-C: Colonoscopy for acute colitis. A safe and reliable tool for assessment of severity. Dig Dis Sci 39:1550–1557, 1994Google Scholar

Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • R.K. Linskens
  • A.A. Van Bodegraven
  • M. Schoorl
  • H.A.R.E. Tuynman
  • P. Bartels

There are no affiliations available

Personalised recommendations