Neurovascular and thromboembolic complications of inflammatory bowel disease in childhood.
Vascular complications occurred in 3.3% (6 of 180) of children with chronic inflammatory bowel disease. Clinical disease activity was severe in four of six patients who presented with these symptoms. In contrast to adults, in whom deep-vein thrombotic complications predominate, the majority of children had involvement of the CNS including encephalopathy, arteritis, arterial occlusion, and thromboembolism. One patient died 3 1/2 years later from progressive intestinal and neurological deficits: morbidity included blindness, epilepsy, and developmental delay. Hematological parameters varied widely. Prevention is not always possible, but risk factors include: (a) family history of collagenosis (83% incidence), (b) severe inanition and immobility, (c) delayed hospitalization, and (d) clinical presentation with cutaneous vasculitis. Therapy must be individualized.
Lloyd-Still
J D
JD
Department of Pediatrics (Divisions of Gastroenterology and Neurology), Northwestern University, Children's Memorial Hospital, Chicago, Illinois 60614.
Tomasi
L
L
D000293:Adolescent; D001927:Brain Diseases / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D011446:Prospective Studies; D013923:Thromboembolism / Q000209:etiology*