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P132. Thromboembolic complications in inflammatory bowel disease patients: Prevalence in a tertiary referral center

P. Markoš, S. Čuković Čavka, R. Zadro, Ž. Krznarić, R. Pulanić, B. Vucelić

University Hospital Centre, Zagreb, Croatia

Background and Aim: The clinical course of inflammatory bowel disease (IBD) patients is frequently associated with thromboembolic complications. The incidence rate of arterial and venous thromboembolic diseases in patients with ulcerative colitis (UC) and Crohn's disease (CD) ranges from 1% to 8% in different series. The contribution of inherited or acquired thrombophilia due to the inflammatory response in thromboembolic complication is still unclear. Thrombotic events are more common in active disease, but also significant numbers of complications can occur in disease remission, so there is a hypothesis that IBD might be an acquired thrombophilic state.

No reports on the prevalence of thromboembolic complications in Croatian IBD patients have been published. This study aimed to evaluate the thromboembolic complications in IBD patients managed at University Hospital Centre Zagreb, a tertiary referral center for IBD.

Materials and Methods: The clinical backgrounds of 238 IBD patients – 146 (61%) with CD and 92 (39%) with UC who have been treated in our unit were analysed retrospectively. The diagnosis of thromboembolic complication was confirmed with appropriate diagnostic methods (color doppler ultrasound or CT angiography). Among prothrombotic risk factors, Factor V Leiden (FVL), prothrombin 20210A (PT20210A), plasminogen activator inhibitor-1 4G/5G (PAI-1 4G/5G) and lupus anticoagulant (LAC) were investigated.

Results: There were 18 (7%) patients that presented with thromboembolic complication, among them 11 (61%) with CD and 7 with UC. The most common localisation was deep vein leg thrombosis (8 patients), with 6 of them presenting with pulmonary embolism. The remaining patients presented with deep vein thrombosis of the arm, and one patient had hepatic vein thrombosis. Among 12 patients tested for prothrombotic risk factors, 7 patients were homozygous for PAI-1 4G/4G, 3 patients were positive for LAC and one patient was heterozygote for PT20210A. Combined prothrombotic risk factors (PAI-1 4G/4G and LAC) were detected in 2 patients.

Conclusion: Incidence of thromboembolic complication in our IBD cohort is similar to the incidences published in other studies. There was a high rate of patients homozygous for PAI-1 mutation in our cohort, but further analysis with much higher number of patient is needed.