Venous thromboembolism has been associated with inflammatory bowel disease (IBD).
In this study, physicians from the Mayo Clinic, Rochester, describe the clinical features, acquired and congenital risk factors, and outcomes of venous thromboembolism in IBD.
The team identified all patients with confirmed IBD and deep venous thrombosis (DVT) or pulmonary embolism (PE) at their institution between 1991 and 2000.
They assessed the patients' medical records for clinical features, risk factors, treatment, and outcomes.
|13% of the Crohn's patients had recurrent deep venous thrombosis or pulmonary embolism.|
|American Journal of Gastroenterology|
The team identified 59 ulcerative colitis (UC) patients and 39 Crohn's disease (CD) patients.
They determined that UC extent was pancolonic in 76%, and CD extent was ileocolonic in 56%, colonic in 23%, and ileal in 21%.
They also found that 80% of CD patients and 79% of UC patients had active disease.
Thrombophilia was present in 33% of the 40 patients tested.
The physicians found that 87% of patients had other risk factors for DVT/PE.
The patients' long-term treatment included warfarin alone (62%), warfarin and IVC filter (18%), and IVC filter alone (7%).
Overall, 13% of the CD patients had recurrent DVT/PE.
The team determined that among the 16 UC patients who underwent proctocolectomy following DVT/PE, there were 2 recurrences (13%). This rate of recurrence was similar that in patients with intact colons.
The mortality rate was 22% after a median follow-up of 1.8 years.
Dr Craig Solem's team concluded, "Venous thromboembolism is a serious complication of IBD that may lead to death".
"Thrombophilia evaluations have a relatively high diagnostic yield overall, although specific genetic abnormalities are individually uncommon".
"Other DVT/PE risk factors are usually present".
"Proctocolectomy is not protective of recurrent DVT/PE".