title: Thrombin generation in pediatric patients with Crohn's disease.
abstract: BACKGROUND
  Patients with inflammatory bowel disease (IBD) have an increased risk of thromboembolic complications. The pathogenesis of IBD is not really clear and a high thrombin activity might contribute to the pathogenesis. We measured thrombin generation by means of calibrated automated thrombography (CAT), a new tool better reflecting overall hemostasis, in children with Crohn's disease (CD) during active and inactive disease and compared it to conventional markers of activity. We wanted to see whether children with CD have a higher potential for thrombin generation and if there is a correlation between hypercoagulability and disease activity.
  
  
  METHODS
  Plasma samples were collected from 22 patients with CD and from 61 healthy children. Thrombin generation was measured by means of CAT. The disease activity was estimated using the Pediatric Crohn's Disease Activity Index (PCDAI). In addition, F1+2, TAT, tissue factor pathway inhibitor (TFPI), fibrinogen, prothrombin (FII), antithrombin (AT), erythrocyte sedimentation rate (ESR), platelet count, α2-globulin, and orosomucoide were measured.
  
  
  RESULTS
  In all patients we found a significantly higher endogenous thrombin potential (ETP) and higher peak values during active disease. In accordance with this we also found significantly higher mean ETP values during active disease compared with the control group. We observed a significantly positive correlation between PCDAI and thrombin generation parameters.
  
  
  CONCLUSIONS
  Our study clearly shows that the active state of CD in children is associated with the potential for high thrombin generation, but this seems to be caused mainly by the inflammatory process and not by a preexisting propensity for high thrombin generation.
authors.affiliation: Department of Pediatrics, Medical University of Graz, Austria.
authors.forename: Heike
authors.initials: H
authors.lastname: Bernhard
authors.forename: Andrea
authors.initials: A
authors.lastname: Deutschmann
authors.forename: Bettina
authors.initials: B
authors.lastname: Leschnik
authors.forename: Sabrina
authors.initials: S
authors.lastname: Schweintzger
authors.forename: Michael
authors.initials: M
authors.lastname: Novak
authors.forename: Almuthe
authors.initials: A
authors.lastname: Hauer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Muntean
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D001780:Blood Coagulation Tests; D002138:Calibration; D016022:Case-Control Studies; D002648:Child; D003424:Crohn Disease / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D011516:Prothrombin / Q000378:metabolism; D013917:Thrombin / Q000378:metabolism*; D013923:Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D011516:Prothrombin; D013917:Thrombin