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. 1993 Feb;34(2):247–251. doi: 10.1136/gut.34.2.247

Thromboembolism in inflammatory bowel disease: role of platelets.

M J Webberley 1, M T Hart 1, V Melikian 1
PMCID: PMC1373979  PMID: 8432482

Abstract

Patients with inflammatory bowel disease are susceptible to thromboembolism and recently small vessel thrombosis has been implicated as an aetiological factor in Crohn's disease. This study therefore investigated platelet function in 104 patients with inflammatory bowel disease of whom eight had previous thromboembolism. Thirty five patients had reproducible spontaneous platelet aggregation of more than 30% (0 in controls) (p < 0.0001). A further 20 patients showed hypersensitivity of platelets to low concentrations of aggregating agents (p < 0.001). Plasma thromboxane B2 and beta thromboglobulin levels were significantly higher than controls (p < 0.001 and p < 0.001), but platelet lifespan studies were normal. There was no correlation with disease activity. Patients with inflammatory bowel disease have abnormal platelet activity, which may contribute to the inflammatory process.

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Selected References

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  1. BARKER N. W. The George E. Brown Memorial Lecture; current status of the problem of thrombosis. Circulation. 1958 Apr;17(4 Pt 1):487–496. doi: 10.1161/01.cir.17.4.487. [DOI] [PubMed] [Google Scholar]
  2. BORN G. V. Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature. 1962 Jun 9;194:927–929. doi: 10.1038/194927b0. [DOI] [PubMed] [Google Scholar]
  3. Best W. R., Becktel J. M., Singleton J. W., Kern F., Jr Development of a Crohn's disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology. 1976 Mar;70(3):439–444. [PubMed] [Google Scholar]
  4. EDWARDS F. C., TRUELOVE S. C. THE COURSE AND PROGNOSIS OF ULCERATIVE COLITIS. III. COMPLICATIONS. Gut. 1964 Feb;5:1–22. doi: 10.1136/gut.5.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Edwards R. L., Levine J. B., Green R., Duffy M., Mathews E., Brande W., Rickles F. R. Activation of blood coagulation in Crohn's disease. Increased plasma fibrinopeptide A levels and enhanced generation of monocyte tissue factor activity. Gastroenterology. 1987 Feb;92(2):329–337. [PubMed] [Google Scholar]
  6. FARMER R. G., SCUDAMORE H. H., BAYRD E. D. COMPARISON OF CLINICAL FINDINGS AND HEMATOLOGIC CHANGES IN PATIENTS WITH CHRONIC ULCERATIVE COLITIS. Am J Gastroenterol. 1963 Dec;40:601–610. [PubMed] [Google Scholar]
  7. Hawker R. J., Hawker L. M., Wilkinson A. R. Indium (111In)-labelled human platelets: optimal method. Clin Sci (Lond) 1980 Mar;58(3):243–248. doi: 10.1042/cs0580243. [DOI] [PubMed] [Google Scholar]
  8. KEHOE E. L., NEWCOMER K. L. THROMBOEMBOLIC PHENOMENA IN ULCERATIVE COLITIS. TWO CASE REPORTS. Arch Intern Med. 1964 May;113:711–715. doi: 10.1001/archinte.1964.00280110091018. [DOI] [PubMed] [Google Scholar]
  9. Knot E., Ten Cate J. W., Leeksma O. C., Tytgat G. N., Vreeken J. No evidence for a prethrombotic state in stable chronic inflammatory bowel disease. J Clin Pathol. 1983 Dec;36(12):1387–1390. doi: 10.1136/jcp.36.12.1387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kondo M., Hotta T., Takemura S., Yoshikawa T., Fukumoto K. Treatment of ulcerative colitis by the direct administration of an antifibrinolytic agent as an enema. Hepatogastroenterology. 1981 Oct;28(5):270–273. [PubMed] [Google Scholar]
  11. Kwaan H. C., Cocco A., Mendeloff A. I., Astrup T. Fibrinolytic activity in the normal and inflamed rectal mucosa. Scand J Gastroenterol. 1969;4(5):441–445. doi: 10.3109/00365526909180630. [DOI] [PubMed] [Google Scholar]
  12. Lam A., Borda I. T., Inwood M. J., Thomson S. Coagulation studies in ulcerative colitis and Crohn's disease. Gastroenterology. 1975 Feb;68(2):245–251. [PubMed] [Google Scholar]
  13. Lee L. C., Spittell J. A., Jr, Sauer W. G., Owen C. A., Jr, Thompson J. H., Jr Hypercoagulability associated with chronic ulcerative colitis: changes in blood coagulation factors. Gastroenterology. 1968 Jan;54(1):76–85. [PubMed] [Google Scholar]
  14. Mori K., Watanabe H., Hiwatashi N., Sugai K., Goto Y. Studies on blood coagulation in ulcerative colitis and Crohn's disease. Tohoku J Exp Med. 1980 Sep;132(1):93–101. doi: 10.1620/tjem.132.93. [DOI] [PubMed] [Google Scholar]
  15. Mustard J. F., Packham M. A. Platelets and diabetes mellitus. N Engl J Med. 1977 Dec 15;297(24):1345–1347. doi: 10.1056/NEJM197712152972408. [DOI] [PubMed] [Google Scholar]
  16. Peters A. M., Saverymuttu S. H., Malik F., Ind P. W., Lavender J. P. Intrahepatic kinetics of indium-111-labelled platelets. Thromb Haemost. 1985 Oct 30;54(3):595–598. [PubMed] [Google Scholar]
  17. Rose P. E., Armour J. A., Williams C. E., Hill F. G. Verotoxin and neuraminidase induced platelet aggregating activity in plasma: their possible role in the pathogenesis of the haemolytic uraemic syndrome. J Clin Pathol. 1985 Apr;38(4):438–441. doi: 10.1136/jcp.38.4.438. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Schwartz B. S., Monroe M. C. Human platelet aggregation is initiated by peripheral blood mononuclear cells exposed to bacterial lipopolysaccharide in vitro. J Clin Invest. 1986 Nov;78(5):1136–1141. doi: 10.1172/JCI112693. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Silverstein A., Present D. H. Cerebrovascular occlusions in relatively young patients with regional enteritis. JAMA. 1971 Feb 8;215(6):976–977. [PubMed] [Google Scholar]
  20. Simi M., Leardi S., Tebano M. T., Castelli M., Costantini F. M., Speranza V. Raised plasma concentrations of platelet factor 4 (PF4) in Crohn's disease. Gut. 1987 Mar;28(3):336–338. doi: 10.1136/gut.28.3.336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. TRUELOVE S. C., WITTS L. J. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2(4947):1041–1048. doi: 10.1136/bmj.2.4947.1041. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Tangen O., Berman H. J., Marfey P. Gel filtration. A new technique for separation of blood platelets from plasma. Thromb Diath Haemorrh. 1971 Jun 30;25(2):268–278. [PubMed] [Google Scholar]
  23. Thompson C. B., Jakubowski J. A., Quinn P. G., Deykin D., Valeri C. R. Platelet size and age determine platelet function independently. Blood. 1984 Jun;63(6):1372–1375. [PubMed] [Google Scholar]
  24. Wakefield A. J., Sawyerr A. M., Dhillon A. P., Pittilo R. M., Rowles P. M., Lewis A. A., Pounder R. E. Pathogenesis of Crohn's disease: multifocal gastrointestinal infarction. Lancet. 1989 Nov 4;2(8671):1057–1062. doi: 10.1016/s0140-6736(89)91078-7. [DOI] [PubMed] [Google Scholar]
  25. Zahavi J. The role of platelets in myocardial infarction, ischemic heart disease, cerebrovascular disease, thromboembolic disorders and acute idiopathic pericarditis. Thromb Haemost. 1977 Dec 15;38(4):1073–1084. [PubMed] [Google Scholar]
  26. de Jong E., Porte R. J., Knot E. A., Verheijen J. H., Dees J. Disturbed fibrinolysis in patients with inflammatory bowel disease. A study in blood plasma, colon mucosa, and faeces. Gut. 1989 Feb;30(2):188–194. doi: 10.1136/gut.30.2.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. ten Cate J. W., Vos J., Oosterhuis H., Prenger D., Jenkins C. S. Spontaneous platelet aggregation in cerebrovascular disease. Thromb Haemost. 1978 Feb 28;39(1):223–229. [PubMed] [Google Scholar]

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