The frequency of thrombosis in inflammatory bowel disease and the effect of thrombosis on the course of the disease

Yıl 2016, , 69 - 72, 02.01.2017

Muhammet Yener Akpınar , Yasemin Özderin Özin Zeki Mesut Yalın Kılıç İsmail Hakkı Kalkan , Mahmut Yüksel İlyas Tenlik Fatih Saygılı Özlem Akdoğan Mustafa Kaplan , Ertuğrul Kayaçetin

https://doi.org/10.17940/endoskopi.337907

Öz

Backgrounds and Aims: Inflammatory bowel disease increases the risk of thrombosis. Here we have present our patients with ulcerative colitis and Crohn’s disease having thrombosis, their clinical course, and the properties of thrombosis in these patients. Materials and Methods: A total of 3.128 patients who were followed up in the Türkiye Yüksek İhtisas Training and Research Hospital Inflammatory Bowel Disease Department were investigated for thrombosis. Results: Of the total, 20 patients with thrombosis were included in the study. The median age of the patients was 40,45 (22-70 years). Of these, 16 patients were men and 6 were women. Thrombosis was diagnosed in deep veins in 10 patients. In addition, 4 patients were diagnosed with pulmonary emboly with deep vein thrombosis, 3 thrombophlebitis, 1 with cerebral vein thrombosis, 1 with mesenteric vein thrombosis, and 2 with portal and hepatic vein thrombosis. The median time between the first inflammatory bowel disease diagnosis and the thrombosis diagnosis was 16 months (2-240). Thrombosis was diagnosed in 15 patients while they were in the active phase of their disease. The treatment of 13 patients was upgraded during their clinical course. Conclusion: Inflammatory bowel disease is a thrombophilic condition. An early diagnosis and appropriate treatment of these patients are essential in order to reduce morbidity and mortality. Thrombosis may predict severe disease. An active disease must be considered as a pre-thrombotic situation, and prophylactic anticoagulation must be integrated within the treatment.

Anahtar Kelimeler

Inflammatory bowel disease, ulcerative colitis, Crohn’s disease, thrombosis

İnflamatuvar barsak hastalıklarında tromboz sıklığı ve trombozun hastalık seyrine olan etkisi

Öz

Giriş ve Amaç: Normal popülasyona göre inflamatuvar barsak hastalığının tromboz riskinde artışla beraber olduğu iyi bilinir. Biz burada ülseratif kolit ve Crohn hastalığı olan hastalarımızda tromboz sıklığını, tromboz saptanan hastaların klinik seyirlerini ve trombozların özelliklerini belirlemeyi amaçladık. Gereç ve Yöntem: Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi İnflamatuvar Barsak Hastalıkları polikliniğinde takip edilen 3128 hasta tromboz yönünden retrospektif olarak incelendi. Bulgular: Çalışmamıza toplam 20 hasta alındı. Hastaların yaş ortalaması 40,45 (22-70) olup 16 hasta erkek, 4 hasta kadındı. Hastalarımızın 10 tanesinde tromboz bacak derin venlerinde iken 4 hastada bacak derin venleriyle beraber pulmoner emboli şeklinde görüldü. 2 hastada tromboflebit, 1 hastada serebral ven trombozu, 1 hastada mezenterik ven trombozu ve 2 hastada da portal ve hepatik ven trombozu olarak görüldü. İlk inflamatuvar barsak hastalığı tanısı ile ilk tromboz tanısı arası geçen süre ortanca 16 ay (2-240)’dı. Trombozlar 15 hastada aktif hastalık esnasında oluşmuştu. 20 hastanın 13 tanesinde tromboz tanısı sonrası aldıkları medikal tedavilerde bir üst basamağa geçiş görüldü. Sonuç: İnflamatuvar barsak hastalığı tromboza zemin hazırlayan bir hastalıktır. Tromboz gelişen hastaların erken tanı ve tedavisi morbidite ve hatta mortalitede azalmaya neden olacaktır. Tromboz ciddi seyredecek inflamatuvar barsak hastalığının habercisi olabilir. Aktif hastalık özellikle pretomboti bir durum olarak değerlendirilmeli ve gerekli antikoagülasyon başlanmalıdır.

Anahtar Kelimeler

İnflamatuvar barsak hastalığı, ülseratif kolit ve Crohn hastalığı, tromboz

Kaynakça

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