title: Onset of Thrombin Generation Occurs More Rapidly in Pediatric Patients With Celiac Disease.
abstract: OBJECTIVE
  Celiac disease (CD) is a risk factor for venous thromboembolism (VTE) and stroke, but the mechanisms are unclear. Continuous measurement of thrombin generation in plasma is a feasible way to detect hypercoagulable changes. The aim of this pilot study was to investigate thrombin generation in pediatric patients with CD compared with pediatric controls.
  
  
  METHODS
  Plasma samples were collected from 19 pediatric patients with CD and 20 healthy controls. In each patient diagnosed as having CD, thrombin generation was determined twice by means of calibrated automated thrombography. The first measurement was undertaken when CD was diagnosed; the second measurement was undertaken after normalization of their IgA antitissue transglutaminase antibody (tTG-Ab) titers following a gluten-free diet. In the controls, measurement for TTG-Ab and thrombin generation was undertaken once during recruitment.
  
  
  RESULTS
  Patients with CD at diagnosis showed a significantly shorter lag time compared with controls (P < 0.001) and a shorter time-to-peak compared with controls (P < 0.02). These differences were no longer detectable after normalization of TTG-Ab values. The overall amount of generated thrombin, represented by the endogenous thrombin potential (ETP), showed no significant difference between the study groups.
  
  
  CONCLUSIONS
  Our results show that alterations in coagulation can be found in untreated CD that may help to explain the described increased risk of stroke or VTE. A shorter lag time in patients with untreated CD indicates a more rapid onset of thrombin generation as a sign of hypercoagulability. ETP, the best predictive parameter for thromboembolic disease, however, was not altered.
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
authors: Andrea
authors: A
authors: Deutschmann
authors: Axel
authors: A
authors: Schlagenhauf
authors: Bettina
authors: B
authors: Leschnik
authors: Karl M
authors: KM
authors: Hoffmann
authors: Almuthe
authors: A
authors: Hauer
authors: Wolfgang
authors: W
authors: Muntean
mesh_terms: D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D002446:Celiac Disease / Q000097:blood* / Q000178:diet therapy; D002648:Child; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D008297:Male; D012307:Risk Factors; D020521:Stroke; D013917:Thrombin / Q000032:analysis*; D011503:Transglutaminases / Q000276:immunology; D054556:Venous Thromboembolism
chemical_list: D007070:Immunoglobulin A; D011503:Transglutaminases; D013917:Thrombin