title: Hyperhomocysteinemia in patients with Crohn's disease.
abstract: BACKGROUND
  Thromboembolic complications have been reported in patients with Crohn's disease. Among the contributing factors, hyperhomocysteinemia has been described, although controversial data exist. The aim of our study was to assess the incidence of hyperhomocysteinemia in a nonselected group of patients with Crohn's disease and to determine whether it might represent a risk marker for thrombosis in such patients.
  
  
  METHODS
  Fifty consecutive patients were recruited, and clinical and laboratory variables were compared between those without and those with hyperhomocysteinemia. In the latter, gene mutations in N5-N10-methyltetrahydrofolate reductase were searched for, and clinical and laboratory variables were related to hyperhomocysteinemia. The presence/absence of thrombotic episodes in both groups was determined.
  
  
  RESULTS
  Both groups had similar clinically active disease, with higher C-reactive protein values found in those with hyperhomocysteinemia. Hyperhomocysteinemia was found in 46 % of patients. Of these, 74 % had moderate, 13 % intermediate, and 13 % severe increase in serum homocysteine levels. No relationship was found between homocysteine levels, and age, vitamin B12 levels, folic acid levels, Crohn's Disease Activity Index score, and CRP values. Gene mutations were found in 5 (22 %) patients, 2 homozygotes and 3 heterozygotes. None of the patients with or without hyperhomocysteinemia had episodes of venous or arterial thrombosis, or stroke.
  
  
  CONCLUSIONS
  Hyperhomocysteinemia is frequent in patients with Crohn's disease, and it could be a cofactor for the pathogenesis of thrombotic episodes.
authors.affiliation: Medical Department, Desio Hospital, Desio, Monza and Brianza, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Casella
authors.forename: E
authors.initials: E
authors.lastname: Antonelli
authors.forename: C
authors.initials: C
authors.lastname: Di Bella
authors.forename: E
authors.initials: E
authors.lastname: Di Marco
authors.forename: M
authors.initials: M
authors.lastname: Piatti
authors.forename: V
authors.initials: V
authors.lastname: Villanacci
authors.forename: S
authors.initials: S
authors.lastname: Bologna
authors.forename: V
authors.initials: V
authors.lastname: Baldini
authors.forename: G
authors.initials: G
authors.lastname: Bassotti
mesh_terms: D000328:Adult; D017677:Age Distribution; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D015897:Comorbidity; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D013923:Thromboembolism / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein