Inflammatory Bowel Disease: An Indication to Screen for Thrombophilia?

Nour M Moukalled,Ali T Taher,Jana G Hashash

doi:10.3390/diseases10010014

Nour M Moukalled, Ali T Taher + Show 1 more

Open Access

https://doi.org/10.3390/diseases10010014

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Abstract

Inflammatory bowel diseases (IBD) are systemic conditions characterized by multiple intestinal and extra-intestinal manifestations related to the associated chronic inflammatory state. Among their diverse extra-intestinal complications, venous thromboembolism (VTE) remains one of the most under recognized causes of morbidity and mortality in these patients, highlighting the need for a better understanding of the underlying mechanism of hypercoagulability, in addition to the role of acquired and inherited risk factors that further increase the risk of thrombosis with its impact on patients’ outcomes. We hereby present a review of the data regarding thrombosis in the setting of IBD, elucidating the possible role for screening in this high-risk category of patients and specifically in areas where inherited thrombophilia is expected to be highly prevalent, reporting two patients with IBD, one who developed a cerebrovascular event and another one who had recurrent VTE events; nevertheless, both of them had inherited thrombophilic mutations. The identification of specific genetic abnormalities in those patients reintroduces the controversy related to the need to screen a specific category of patients with IBD for hereditary thrombophilia, especially in regions characterized by a higher prevalence of such thrombophilic alterations.

Highlights

The identification of specific genetic abnormalities in those patients reintroduces the controversy related to the need to screen a specific category of patients with Inflammatory bowel diseases (IBD) for hereditary thrombophilia, especially in regions characterized by a higher prevalence of such thrombophilic alterations
Inflammatory bowel diseases (IBD) are inflammatory conditions of the gastrointestinal tract which are categorized into ulcerative colitis (UC) and Crohn’s disease (CD)
This has led to the controversial discussion related to the need to screen such patients for genetic mutations that would further increase their risk for developing venous thromboembolism (VTE) events, especially in areas characterized by high prevalence of such inherited abnormalities, including the Mediterranean region

Summary

Introduction

Inflammatory bowel diseases (IBD) are inflammatory conditions of the gastrointestinal tract which are categorized into ulcerative colitis (UC) and Crohn’s disease (CD). We hereby present a review of the data regarding thrombosis in the setting of IBD, elucidating the possible role for screening in this high-risk category of patients and in areas where inherited thrombophilia is expected to be highly prevalent, reporting two patients with IBD, one who developed a cerebrovascular event and another one who had recurrent VTE events; both of them had inherited thrombophilic mutations.

Results

Conclusion