Calibrated automated thrombin generation in paediatric patients with inflammatory bowel disease

Summary

In adults, inflammatory bowel disease (IBD) is associated with an increased risk of thromboembolic complications. The pathogenesis of IBD is not really clear and a high thrombin activity might contribute to disease progression. We wanted to see whether children with IBD have a higher thrombin generation (TG). Patients, material, methods: Plasma samples were collected of 20 patients with IBD and of 60 healthy controls (age range from 10 to 19). TG was measured by means of Calibrated automated thrombography (CAT). The disease activity was estimated, using the Pediatric Crohn‘s Disease Activity Index (PCDAI) for Crohn‘s disease and the Pediatric Ulcerative Colitis Disease Activity Index (PUCAI) for Ulcerative Colitis. In addition, we investigated F1+F2, TAT, TFPI and fibrinogen. Results: There was a significant increase of endogenous thrombin potential (ETP), lag time and time to peak in patients with IBD, while peak showed no difference to healthy controls. ETP and F1+F2 in children with IBD also showed a significant correlation with PCDAI (PUCAI) and fibrinogen. Conclusion: IBD in children is associated with high TG, but this seems to be caused mainly by the inflammatory process and not by any individual disposition.

Zusammenfassung

Bei Erwachsenen mit chronisch-entzündlicher Darmerkrankung (CED) besteht ein erhöhtes Risiko für thromboembolische Komplikationen. Die Pathogenese von CED ist nicht wirklich geklärt, ein hohes Thrombinpotenzial könnte zur Progression dieser Erkrankungen beitragen. Wir untersuchten, ob bei Kindern mit CED eine höhere Thrombingeneration (TG) besteht. Patienten, Material, Methoden: Wir untersuchten Plasmaproben von 20 Patienten mit CED und 60 gesunden Kontrollen (Alter: 10–19 Jahre). Die kontinuierliche Mes-sung der TG erfolgte für unsere Studie mittels CAT Methode. Die Aktivität der Erkrankung definierten wir mittels Indices wie den Pediatric Crohn‘s Disease Activity Index (PCDAI) für den Mb.Crohn und den Pediatric Ulcerative Colitis Disease Activity Index (PUCAI) für die Colitis ulcerosa. Zusätzlich bestimmten wir F1+F2, TAT, TFPI und Fibrinogen. Ergebnisse: Es gab einen signifikanten Anstieg des endogenen Thrombinpotenzials (ETP), der lag time und time to peak bei Patienten mit CED, wäh-rend der Peak keinen Unterschied zu der gesunden Kontrollgruppe zeigte. Das ETP und F1+F2 zeigte bei Kindern mit CED eine signifikante Korrelation mit den Aktivitätsindices und mit Fibrinogen. Schlussfolgerung: CED ist bei Kindern mit einer erhöhten TG assoziiert. Es scheint, dass dies hauptsächlich durch den entzündlichen Prozess und nicht durch die individuelle Disposition verursacht wird.

Keywords

Calibrated automated thrombography - endogenous thrombin potential - inflammatory bowel disease

Schlüsselwörter

Kalibrierte automatisierte Thrombographie - endogenes Thrombinpotenzial - chronisch entzündliche Darmerkrankung

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