Inflammatory response in the acute phase of deep vein thrombosis.
OBJECTIVE
Deep vein thrombosis (DVT) is a multifactorial disease. Recently, inflammation has been suggested as a risk factor for DVT. The question is whether inflammation is a cause of venous thrombosis or rather a result of the thrombotic process.


METHODS
We studied the inflammatory response in the acute phase of DVT with interleukin-6, interleukin-8, and C-reactive protein (CRP) as inflammatory markers. Plasma concentrations were measured on the day of admission (day 0) in 40 patients with acute DVT confirmed with phlebography and in 33 patients with clinical suspicion of DVT but negative phlebography results (controls). In patients with DVT, inflammatory markers were also examined on five subsequent days.


RESULTS
On day 0, the median concentrations in plasma of interleukin-6, interleukin-8, and CRP were 15.0 pg/mL (range, <3 to 70 pg/mL), 7.0 pg/mL (range, <3 to 76 pg/mL), 37.5 mg/L (range, <7 to 164 mg/L), respectively, in the patient group and less than 3 pg/mL (range, <3 to 11 pg/mL; P <.001), 6.0 pg/mL (range, <3 to 52 pg/mL; P =.08), and 5.0 pg/L (range, <7 to 66 pg/L; P <.001), respectively, in the controls. During the next days, interleukin-6 concentration showed a gradual decline in patients with DVT from 15.0 to 5.5 pg/mL (P <.001), interleukin-8 concentration was relatively constant in time, and CRP concentration declined from 37.5 to 21.5 mg/L (P =.01).


CONCLUSIONS
Our data show an apparent inflammatory response with highest measured concentrations of inflammatory markers on the day of admission and a subsequent decrease during the next days. This response supports the hypothesis that elevated inflammatory markers are a result rather than a cause of venous thrombosis.
Roumen-Klappe
Edith M
EM
Department of General Internal Medicine, University Medical Center Nijmegen, The Netherlands. E.Roumen@aig.azn.nl
den Heijer
Martin
M
van Uum
Stan H M
SH
van der Ven-Jongekrijg
Johanna
J
van der Graaf
Fedde
F
Wollersheim
Hub
H
D000210:Acute-Phase Reaction / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis / Q000276:immunology*
D005338:Fibrin Fibrinogen Degradation Products; D015850:Interleukin-6; D016209:Interleukin-8; C036309:fibrin fragment D; D002097:C-Reactive Protein