Abstract
Alterations in markers of coagulation have been found in patients with inflammatory bowel disease. Our aim was to study the predictive value of coagulation and inflammatory parameters in the course of severe ulcerative colitis. Twenty-seven patients were included. The disease course was followed for one year. Sensitivity, specificity, negative predictive value, positive predictive value, and likelihood ratio, as well as the clinical predictive value of laboratory variables were calculated. Inflammatory variables, such as ESR, CRP, and leukocyte and platelet count showed poor diagnostic accuracy. Several coagulation parameters, such as fibrinogen and fibrin(ogen) degradation products, were increased in patients with active ulcerative colitis, whereas coagulation factor XIII was decreased. No significant relationship between clinical course and coagulation parameters was demonstrated, though both inflammatory and coagulation parameters were useful in the assessment of disease activity in patients with active ulcerative colitis.
Similar content being viewed by others
REFRENCES
Hanauer SB: Medical therapy for ulcerative colitis. In Inflammatory Bowel Disease. JB Kirsner (ed). Philadelphia, WB Saunders, 2000, pp 529–556
Wedel S, Schreiber S: Laboratory tests in inflammatory bowel disease. In Inflammatory Bowel Diseases-From Bench to Bedside. T Andus, H Goebell, P Layer, J Schölmerich (eds). Dordrecht, Kluwer Academic, 1996, pp 235–241
Weeke B, Jarnum S: Serum concentrations of 19 serum proteins in Crohn's disease and ulcerative colitis. Gut 12:292–303, 1969
Buckell NA, Lennard-Jones JE, Hernandez MA, Kohn J, Riches PG, Wadsworth J: Measurements of serum proteins during attacks of ulcerative colitis as a guide to patient management. Gut 20:22–27, 1979
Prantera C, Davoli M, Lorenzetti R, Pallone F, Marcheggiano A, Iannoni C, Mariotti S: Clinical and laboratory indicators of extent of ulcerative colitis. J Clin Gastroenterol 10:41–45, 1988
Travis SPL, Farrant JM, Ricketts C, Nolan DJ, Martenson NM, Kettlewell MGW, Jewell DP: Predicting outcome in severe ulcerative colitis. Gut 38:905–910, 1996
Rees DC, Satsangi J, Cornelissen PL, Travis SP, White J, Jewell DP: Are serum concentrations of nitric oxide metabolites useful ifor predicting the clinical outcome of severe ulcerative colitis? Eur J Gastroenterol Hepatol7:227–230, 1995
van Wersch JWJ, Houben P, Rijken J: Platelet count, platelet function, coagulation activity and fibrinolysis in the acute phase of inflammatory bowel disease. J Clin Chem Clin Biochem 28:513–517, 1990
van Bodegraven AA, Tuynman HARE, Schoorl M, Kruishoop AM, Bartels PCM: Fibrinolytic split products, fibrinolysis, and factor XIII activity in inflammatory bowel disease. Scand J Gastroenterol 30:580–585, 1995
Souto JC, Martinez E, Roca M, Mateo J, Pujol J, Gonzales D, Fontcuberta J: Prothrombotic state and signs of endothelial lesions in plasma of patients with inflammatory bowel disease. Dig Dis Sci 40:1883–1889, 1995
Chamouard P, Grunebaum L, Wiesel M-P, Frey PL, Wittersheim C, Sapin R, Baumann R, Cazenave JP: Prothrombin fragment 1 + 2 and thrombin-antithrombin III complex as markers of activation of blood coagulation in inflammatory bowel disease. Eur J Gastroenterol Hepatol 7:1183–1188, 1995
van der Heide H, van der Brandt-Gradel V, Tytgat GNJ, Endert E, Wiltink EHH, Schipper MEI, Dekker W: Comparison of beclomethasone diproprionate and prednisolone 21-phosphate enemas in the treatment of ulcerative proctitis. J Clin Gastroenterol 10:169–172, 1988
Chambless L, McMahon R, Wu K, Folsom A, Finch A, Shen Y-L: Short-term intraindividual variability in hemostasis factors. Ann Epidemiol 2:723–733, 1992
Salomaa VV, Rasi V, Stengard J, Vahtera E, Pekkanen J, Vartiainen J, Ehnholm C, Puska, P: Intra-and interindividual variability of hemostatic factors and traditional cardiovascular risk factors in three-year follow-up. Thromb Haemost 79: 969–974, 1998
Lee JCL, Spittell JA, Sauer WG, Owen CA, Thompson JH: Hypercoagulability associated with chronic ulcerative colitis. Changes in blood coagulation factors. Gastroenterology 54: 76–84, 1968
Lake AM, Stauffer JQ, Stuart MJ: Hemostatic alterations in inflammatory bowel disease. Am J Dig Dis 23:897–902, 1978
Lam A, Borda IT, Inwood MJ, Thompson S: Coagulation studies in ulcerative colitis and Crohn's disease. Gastroenterology 68:245–251, 1975
Talbot RW, Heppell J, Dozois RR, Beart RWJ: Vascular complications of inflammatory bowel disease. Mayo Clin Proc 61:140–145, 1986
Edwards RL, Levine JB, Green R, Duffy M, Mathews E, Brande W, Rickles FR: Activation of blood coagulation in Crohn's disease. Increased plasma fibrinopeptide A levels and enhanced generation of monocyte tissue factor activity. Gastroenterology 92:329–337, 1987
Roberts HR, Tabares AH: Overview of the coagulation reactions. In Molecular Basis of Thrombosis and Hemostasis. KA High, HR Roberts (eds). New York, Marcel Dekker, 1995, pp 35–50
Nieuwenhuizen W: Quantitative enzyme immunoassays for degradation products of fibrinogen (FgDP), fibrin (FbDP) and total of FgDP and FbDP (TDP). In ECAT assay procedures. A manual of laboratory techniques. J Jespersen, RM Bertina, F Haverkate (eds). Dordrecht, Kluwer, 1992, pp 191–203
Souto JC, Martinez E, Roca M, Mateo J, Pujol J, Condomines J, et al: Low levels of plasminogen activator inhibitor type 1 in patients with inflammatory bowel disease. Fibrinolysis 8: 359–363, 1994
Boisclair MD, Ireland H, Lane DA: Assessment of hypercoagulable states by measurement of activation fragments and peptides. Blood Rev 4:25–40, 1990
Dempfle C-E, Kontny F, Abildgaard U: Predictive value of coagulation markers concerning clinical outcome 90 days after anterior myocardial infarction. Thromb Haemost 81:701–704, 1999
Kjeldsen J, Schaffalitzky de Muckadell OB: Assessment of disease severity and activity in inflammatory bowel disease. Scand J Gastroenterol 28:1–9, 1993
Fareed J, Hoppenstedt D, Bick RL, Bacher P: Drug-induced alterations of hemostasis and fibrinolysis. Hematol Oncol Clin North Am 6:1229–1245, 1992
Geboes K, Delabie J, Rutgeerts P, Vantrappen G: Endoscopy as a diagnostic tool in inflammatory bowel disease. Acta Chir Belg 89(2):106–110, 1989
Haber GB: Role of endoscopy in inflammatory bowel disease. Dig Dis Sci 32(suppl):16S–25S, 1987
Carbonnel F, Lavergne A, Lémann M, Bitoun A, Valleur P, Hautefeuille P, Galian A, Modigliani R, Rambaud J-C: Colonoscopy for acute colitis. A safe and reliable tool for assessment of severity. Dig Dis Sci 39:1550–1557, 1994
Rights and permissions
About this article
Cite this article
Linskens, R., Van Bodegraven, A., Schoorl, M. et al. Predictive Value of Inflammatory and Coagulation Parameters in the Course of Severe Ulcerative Colitis. Dig Dis Sci 46, 644–648 (2001). https://doi.org/10.1023/A:1005628005734
Issue Date:
DOI: https://doi.org/10.1023/A:1005628005734