BALANCING THE THROMBOTIC RISK AND THE HEMORRHAGIC RISK IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE AND DEEP VEIN THROMBOSIS. CASE REPORT
Keywords:
ANTICOAGULANTS, VENOUS THROMBOEMBOLISM, INFLAMMATORY BOWEL DISEASEAbstract
The thrombotic events occurring in patients with inflammatory bowel disease are currently recognized as a form of extraintestinal manifestation of the disease. We present the case of a 35-year-old Caucasian male with inflammatory bowel disease and deep vein thrombosis, drawing attention to the particularities of the venous thrombotic events in this category of patients: high thrombotic risk, peak incidence at young age, high risk of recurrence. We state the correct anticoagulant treatment based on current evidence and guidelines recommendations, highlighting the importance of a careful assessment of both the thrombotic and hemorrhagic risk of the patient. Special attention has been paid to the new oral anticoagulants and to the latest recommendations of specialized guidelines.
References
2. Papa A, Gerardi V, Marzo M, Felice C, Rapaccini GL, Gasbarrini A. Venous thromboembolism in patients with inflammatory bowel disease: Focus on prevention and treatment. World J Gastroenterol 2014; 20(12): 3173-3179.
3. Novacek G, Weltermann A, Sobala A, et al. Inflammatory bowel disease is a risk factor for recurrent venous thromboembolism. Gastroenterology 2010; 139(3): 779-787.
4. Giannotta M, Tapete G, Emmi G, Silvestri E, Milla M. Thrombosis in inflammatory bowel diseases: What’s the link? Thromb J 2015; 13: 14.
5. Marineaţă A, Rezuş E, Mihai C, Cijevschi Prelipcean C: Extra-intestinal manifestations and compli-cations in inflammatory bowel disease. RMC (MSJ) 2014; 2: 279-288.
6. Nguyen G, Bernstein C, Bitton A, et al. Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology. Gastroenterology 2014; 146: 835-848.
7. Scaldaferri F, Lancellotti S, Pizzoferrato M, De Cristofaro R. Haemostatic system in inflammatory bowel diseases: new players in gut inflammation. World J Gastroenterol 2011; 17(5): 594-608.
8. Miehsler W, Reinisch W, Valic E, et al. Is inflammatory bowel disease an independent and disease specific risk factor for thromboembolism? Gut 2004; 53(4): 542-548.
9. Bernstein CN, Blanchard JF, Houston DS, Wajda A. The incidence of deep venous thrombosis and pulmonary embolism among patients with inflammatory bowel disease: a population-based cohort study. Thromb Haemost 2001; 85: 430-434.
10. Kappelman MD, Horvath-Puho E, Sandler RS, et al. Thromboembolic risk among Danish children and adults with inflammatory bowel diseases: a population-based nationwide study. Gut 2011; 60: 937-943.
11. Grainge MJ, West J, Card TR. Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study. Lancet 2010; 375: 657-663.
12. Nguyen GC, Bernstein CN. Duration of anticoagulation for the management of venous thromboembo-lism in inflammatory bowel disease: a decision analysis. Am J Gastroenterol 2013; 108(9): 1486-1495.
13. Harbord M, Annese V, Vavricka SR et al. The first European evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease. J Crohns Colitis 2016; 10(3): 239-254.
14. Sardar P, Chatterjee S, Lavie CJ, Giri JS, Ghosh J, Mukherjee D, Lip GY. Risk of major bleeding in different indications for new oral anticoagulants: insights from a meta-analysis of approved dosages from 50 randomized trials. Int J Cardiol 2015; 179: 279-287.
15. van der Hulle T, Kooiman J, den Exter PL, Dekkers OM, Klok FA, Huisman MV. Effectiveness and safety of novel oral anticoagulants as compared with vitamin K antagonists in the treatment of acute symptomatic venous thromboembolism: a systematic review and meta-analysis. J Thromb Haemost 2014; 12(3): 320-328.
16. Ruff CT, Giugliano RP, Braunwald E. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: A meta-analysis of randomized trials. Lancet 2014; 383(9921): 955-962.
17. Galanis T, Keiffer G, Merli G. The new oral anticoagulants for the treatment of venous thromboem-bolism: A new paradigm shift in antithrombotic therapy. Curr Ther Res Clin Exp 2014; 76: 76-83.
18. Kim SH, Jang S, Sung Y et al. Use of novel oral anticoagulant to treat pulmonary thromboembolism in patient with ulcerative colitis superinfected Cytomegalovirus colitis. Korean J Gastroenterol 2017; 70(1): 44-49.
Additional Files
Published
Issue
Section
License
COPYRIGHT
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
_____________________________________________________________________________________
_____________________________________________________________________________________
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
- ______________________________/_________________________
- ______________________________/_________________________
- ______________________________/_________________________
N.B. All the authors must sign this form