P155 Thrombophilias and thromboembolic events in a population of patients with inflammatory bowel disease
J. Pinho*, D. Martins, P. Sousa, P. Ministro, E. Cancela, R. Araújo, A. Castanheira, A. Silva
Centro Hospitalar Tondela/Viseu, Viseu, Portugal
Previous studies have demonstrated that patients with inflammatory bowel disease (IBD) have a 3-fold risk for thrombotic events compared with the general population. The aim of this study was to characterise the population of patients with IBD and thrombophilias/thromboembolic events followed in the gastroenterology consultation of our hospital, and evaluate if there is an association between the disease features and thromboembolic events.
We did a prospective evaluation of a population of patients with IBD and the diagnosis of thrombophilias and/or thromboembolic events.
Amongst 340 patients with IBD followed in the gastroenterology consultation, 8 patients were included, 3 men and 5 women, with an average age of 42.9 years. Further, 7 had the diagnosis of Crohn’s disease (88%) and 1 had ulcerative colitis. According to the Montreal classification, 86% (n = 6) of the patients with Crohn disease had ileal disease and 14% ileocolic disease; 3 patients (42%) had non-stricturing, non-penetrating disease; 2 patients had stricturing disease; and 2 penetrating disease; the patient with ulcerative colitis had a pancolitis. Moreover, 7 patients had the diagnosis of thrombophilia, and the majority of them had been diagnosed during a thromboembolic event. Thromboembolic events occurred in 5 (86%) of the 7 patients with thrombophilia, and 1 in a patient without thrombophilia. In addition, 4 ischaemic strokes, 1 central retinal artery thrombosis, 1 venous sinus thrombosis, 1 jugular venous thrombosis, and 1 transient ischaemic attack were recorded. In addition, 1 patient showed positive anti-β2 microglobulin antibody; 3 showed positive lupus anticoagulant with MTHFR C677T homozygosity; 1 MTHFR C677T homozygosity, 1 positive lupus anticoagulant with MTHFR C677T heterozygosity; and 1 with positive lupus anticoagulant and MTHFR A1298C and C677T heterozygosity. Amongst the patients with thromboembolic events, 5 had Crohn’s disease and 1 ulcerative colitis. The average age was 45.6 years with an average disease-evolution time of 61.2 months. The average Harvey–Bradshaw score was 5.4, and Mayo score was 11. Average erythrocyte sedimentation rate was 23 mm, and C-reactive protein was 2.97 mg/dL. It was necessary to optimise therapeutic in 2 patients.
In our study, most of the patients with IBD and thrombophilias presented a thromboembolic event. Thromboembolic events were more frequent in Crohn’s disease, with highest clinical activity scores.