Fibrinolytic split products, fibrinolysis, and factor XIII activity in inflammatory bowel disease.
BACKGROUND
Factor XIII (F XIII), the last coagulation factor in the clotting cascade, plays a role in mucosal repair. Beneficial effects of F XIII supplementation in severe ulcerative colitis (UC) have been observed. The aim of this study was to relate plasma F XIII activity to the severity of inflammatory bowel disease (IBD).


METHODS
A transversional and, in part, longitudinal study of F XIII activity and related clotting products was performed in 39 patients with UC, 31 patients with Crohn's disease (CD), and 20 controls. Disease activity was assessed with a combined activity score in UC and with the Dutch Activity Index in CD.


RESULTS
F XIII activity was decreased in active UC (p < 0.05) and active CD (p < 0.05) and was inversely correlated with severity in both UC (r = -0.30) and CD (r = -0.46). In six patients with UC (15%) and six patients with CD (19%) F XIII activity was below the lower range of normal. In these patients apparent rectal bleeding was only found in severe UC. Hyperfibrinolysis was indicated by elevated levels of D-dimer (p < 0.001) notwithstanding increased concentrations of alpha-2 antiplasmin (p < 0.05).


CONCLUSIONS
In active IBD we found decreased plasma F XIII activity and hyperfibrinolysis. Decreased F XIII activity was not associated with apparent rectal bleeding in IBD.
Van Bodegraven
A A
AA
Dept. of Internal Medicine, Medical Centre Alkmaar, The Netherlands.
Tuynman
H A
HA
Schoorl
M
M
Kruishoop
A M
AM
Bartels
P C
PC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003093:Colitis, Ulcerative / Q000097:blood / Q000473:pathology / Q000503:physiopathology; D003424:Crohn Disease / Q000097:blood / Q000473:pathology / Q000503:physiopathology; D005176:Factor XIII / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis
D005176:Factor XIII