A clinical case of hereditary thrombophilia in a patient with ulcerative colitis

Cover Page


Cite item

Full Text

Abstract

We present  a clinical case of a 24-year old female patient  who was hospitalized  with high active ulcerative  colitis associated  with  latent  hereditary thrombophilia  uncontrolled  due  to  the  exacerbation  of ulcerative colitis and local steroid treatment. The patient  was treated with combination of systemic steroids, adalimumab and anticoagulants. We emphasize  the necessity of the multidisciplinary approach  to her treatment. The clinical case demonstrates the possibility of safe use of anticoagulants to prevent  thromboembolic complications in patients  with ulcerative colitis and high risk of thrombus formation, under careful monitoring of coagulation  parameters and thromboelastography. We discuss the need  in clear guidelines to determine treatment strategy for patients  with inflammatory bowel diseases, coagulopathies and thromboembolic complications.

About the authors

N. A. Fadeeva

Moscow Clinical Scientific Center, Moscow Healthcare Department

Author for correspondence.
Email: chuevana@mail.ru

Fadeeva Nina A. – MD, PhD, Senior Research Fellow, Department of Inflammatory Bowel Diseases.

86 Shosse Entuziastov, Moscow, 111123, +7 (926) 484 85 90

Russian Federation

I. A. Donchenko

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Donchenko Irina A. – MD, Gastroenterologist, Department of Inflammatory Bowel Diseases.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

O. V. Knyazev

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Knyazev Oleg V. – MD, PhD, Head of Department of Inflammatory Bowel Diseases.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

A. A. Lishchinskaya

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Lishchinskaya Al'bina A. – MD, PhD, Senior Research Fellow, Department of Inflammatory Bowel Diseases.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

G. A. Dudina

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Dudina Galina A. – MD, PhD, Senior Research Fellow, Department of Oncohematology.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

I. N. Ruchkina

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Ruchkina Irina N. – MD, PhD, Leading Research Fellow, Department of Inflammatory Bowel Diseases.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

V. V. Subbotin

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Subbotin Valeriy V. – MD, PhD, Head of Center of Anesthesiology and Intensive Care.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

K. K. Noskova

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Noskova Karina K. – MD, PhD, Head of Laboratory.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

V. A. Rogozina

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Rogozina Vera A. – MD, Endoscopist, Diagnostic Endoscopy Department.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

A. I. Parfenov

Moscow Clinical Scientific Center, Moscow Healthcare Department

Email: fake@neicon.ru

Parfenov Asfold I. – MD, PhD, Professor, Head of Department of Bowel Diseases.

86 Shosse Entuziastov, Moscow, 111123

Russian Federation

References

  1. Algahtani FH, Farag YM, Aljebreen AM, Alazzam NA, Aleem AS, Jabri FF, Rajab MH, Shoukri MM. Thromboembolic events in patients with inflammatory bowel disease. Saudi J Gastroenterol. 2016;22(6):423–7. doi: 10.4103/1319-3767.195558.
  2. Yoshida H, Granger DN. Inflammatory bowel disease: a paradigm for the link between coagulation and inflammation. Inflamm Bowel Dis. 2009;15(8):1245–55. doi: 10.1002/ibd.20896.
  3. Nguyen GC, Sam J. Rising prevalence of venous thromboembolism and its impact on mortality among hospitalized inflammatory bowel disease patients. Am J Gastroenterol. 2008;103(9):2272–80. doi: 10.1111/j.1572-0241.2008.02052.x.
  4. Giannotta M, Tapete G, Emmi G, Silvestri E, Milla M. Thrombosis in inflammatory bowel diseases: what's the link? Thromb J. 2015;13:14. doi: 10.1186/s12959-015-0044-2.
  5. Lee LC, Spittell JA Jr, Sauer WG, Owen CA Jr, Thompson JH Jr. Hypercoagulability associated with chronic ulcerative colitis: changes in blood coagulation factors. Gastroenterology. 1968;54(1):76–85. doi: http://dx.doi.org/10.1016/S0016-5085(68)80041-1.
  6. Lam A, Borda IT, Inwood MJ, Thomson S. Coagulation studies in ulcerative colitis and Crohn's disease. Gastroenterology. 1975;68(2): 245–51. doi: http://dx.doi.org/10.1016/S0016-5085(75)80005-9.
  7. Lake AM, Stauffer JQ, Stuart MJ. Hemostatic alterations in inflammatory bowel disease: response to therapy. Am J Dig Dis. 1978;23(10):897–902.
  8. Souto JC, Martínez E, Roca M, Mateo J, Pujol J, González D, Fontcuberta J. Prothrombotic state and signs of endothelial lesion in plasma of patients with inflammatory bowel disease. Dig Dis Sci. 1995;40(9):1883–9. doi: https://doi.org/10.1007/BF02208650.
  9. Heneghan MA, Cleary B, Murray M, O'Gorman TA, McCarthy CF. Activated protein C resistance, thrombophilia, and inflammatory bowel disease. Dig Dis Sci. 1998;43(6):1356–61. doi: https://doi.org/10.1023/A:1018840715357.
  10. Chamouard P, Grunebaum L, Wiesel ML, 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 diseases. Eur J Gastroenterol Hepatol. 1995;7(12):1183–8.
  11. Jorens PG, Hermans CR, Haber I, Kockx MM, Vermylen J, Parizel GA. Acquired protein C and S deficiency, inflammatory bowel disease and cerebral arterial thrombosis. Blut. 1990;61(5):307–10.
  12. Aadland E, Odegaard OR, Røseth A, Try K. Free protein S deficiency in patients with Crohn's disease. Scand J Gastroenterol. 1994;29(4):333–5. doi: https://doi.org/10.3109/00365529409094844.
  13. Owczarek D, Cibor D, Głowacki MK, Rodacki T, Mach T. Inflammatory bowel disease: epidemiology, pathology and risk factors for hypercoagulability. World J Gastroenterol. 2014;20(1):53–63. doi: 10.3748/wjg.v20.i1.53.
  14. Yuhara H, Steinmaus C, Corley D, Koike J, Igarashi M, Suzuki T, Mine T. Meta-analysis: the risk of venous thromboembolism in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2013;37(10):953–62. doi: 10.1111/apt.12294.

Supplementary files

There are no supplementary files to display.


Copyright (c) 2017 Fadeeva N.A., Donchenko I.A., Knyazev O.V., Lishchinskaya A.A., Dudina G.A., Ruchkina I.N., Subbotin V.V., Noskova K.K., Rogozina V.A., Parfenov A.I.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies