Venous thromboembolism in inflammatory bowel disease.
OBJECTIVE
Venous thromboembolism has been associated with inflammatory bowel disease (IBD). We sought to describe the clinical features, acquired and congenital risk factors, and outcomes of venous thromboembolism in IBD.


METHODS
All patients with confirmed IBD and deep venous thrombosis (DVT) or pulmonary embolism (PE) at our institution between 1991 and 2000 were identified. Medical records were abstracted for clinical features, risk factors, treatment, and outcomes.


RESULTS
Fifty-nine ulcerative colitis (UC) patients (68% males) and 39 Crohn's disease (CD) patients (41% males) were identified. UC extent was pancolonic in 76%, and CD extent was ileocolonic in 56%, colonic in 23%, and ileal in 21%. Eighty percent of CD patients and 79% of UC patients had active disease. Thrombophilia was present in 33% of the 40 patients tested. Most patients (87%) had other risk factors for DVT/PE. Long-term treatment included warfarin alone (62%), warfarin and IVC filter (18%), and IVC filter alone (7%). Five CD patients (13%) had recurrent DVT/PE. Among the 16 UC patients who underwent proctocolectomy following DVT/PE, there were two recurrences (13%), similar to the three recurrences (10%) seen among the 29 patients who had intact colons. Mortality rate was 22% after a median follow-up of 1.8 yr.


CONCLUSIONS
Venous thromboembolism is a serious complication of IBD that may lead to death. Thrombophilia evaluations have a relatively high diagnostic yield overall, although specific genetic abnormalities are individually uncommon. Other DVT/PE risk factors are usually present. Proctocolectomy is not protective of recurrent DVT/PE.
Solem
Craig A
CA
Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Loftus
Edward V
EV
Tremaine
William J
WJ
Sandborn
William J
WJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications*; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications / Q000175:diagnosis; D020246:Venous Thrombosis / Q000150:complications*