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Semin Thromb Hemost 2023; 49(07): 744-755
DOI: 10.1055/s-0042-1758869
Review Article

The Journey Through the Pathogenesis and Treatment of Venous Thromboembolism in Inflammatory Bowel Diseases: A Narrative Review

Andrea Boccatonda
1   Department of Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Bologna, Italy
,
Marco Balletta
2   Department of Internal Medicine, Bologna University, Bologna, Italy
,
Susanna Vicari
1   Department of Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Bologna, Italy
,
Ariela Hoxha
3   Hemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
,
Paolo Simioni
3   Hemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
,
Elena Campello
3   Hemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy
› Author Affiliations
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Abstract

Inflammatory bowel diseases (IBDs) are chronic inflammatory disorders of the gastrointestinal tract including Crohn's disease and ulcerative colitis, which may result in several extraintestinal complications (∼20–30% of cases), such as increased risk of venous thromboembolism (VTE). The main pathophysiological mechanism of VTE is an inflammation-induced hypercoagulable state, and recent data have shown that endothelial dysregulation due to gut and systemic inflammation may also lead to a prothrombotic state. Several prothrombotic alterations have been described, such as the activation of the coagulation system, platelet abnormalities, and dysregulation of fibrinolysis. Furthermore, the dysregulation of the gut microbiome seems to play a vital role in increasing systemic inflammation and thus inducing a procoagulant state. Our review aims to examine the main correlations between IBD and VTE, the underlying pathophysiology, and current therapeutic options.

Keywords

immunothrombosis - hypercoagulability - pulmonary embolism - thromboinflammation - venous thrombosis


Publication History

Article published online:
01 December 2022

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