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Resistance to activated protein C and low levels of free protein S in Greek patients with inflammatory bowel disease.
Am J Gastroenterol 2000; 95(1):190-4AJ

Abstract

OBJECTIVE

Patients with inflammatory bowel disease (IBD) frequently suffer from thromboembolic events. A recently identified mechanism for thrombophilia, the poor anticoagulant response to activated protein C, has been suggested as one of the leading risk factors for thrombosis. The aim of this study was to evaluate the frequency of thrombophilic abnormalities, including activated protein C-resistance (APCR), in Greek patients with ulcerative colitis (UC) and Crohn's disease (CD).

METHODS

Forty-eight patients with UC, 36 with CD, and 61 matched healthy controls (HC) were studied. Cases with presence of lupus anticoagulant, use of anticoagulants or heparin, and pregnancy were excluded. Disease activity in CD was evaluated by use of the Crohns Disease Activity Index (CDAI) score and in UC by the Truelove-Witts grading system. Plasma levels of protein C, free protein S, antithrombin III (AT-III), activated protein C resistance (APCR), and fibrinogen were determined in IBD patients, as well as in HC. All the cases and controls with abnormal APCR were further studied by genetic testing for the factor V Leiden mutation.

RESULTS

Mean fibrinogen levels in UC and CD patients were significantly elevated (p<0.0001), compared with HC. The mean values of free protein S, as well as mean APCR, were significantly lower in UC and CD patients than in the HC (p<0.0001). Seven (five UC and two CD) of 84 IBD patients (8.3%) and three of the HC (4.9%) had the factor V Leiden mutation. No significant difference was observed for the other thrombophilic parameters. Fibrinogen levels and profound free protein S deficiency were found related to disease activity.

CONCLUSIONS

Thrombophilic defects are common in Greek patients with IBD and they could interfere either in the disease manifestation or in the thrombotic complications.

Authors+Show Affiliations

Department of Gastroenterology, University Hospital of Heraklion, Crete, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10638581

Citation

Koutroubakis, I E., et al. "Resistance to Activated Protein C and Low Levels of Free Protein S in Greek Patients With Inflammatory Bowel Disease." The American Journal of Gastroenterology, vol. 95, no. 1, 2000, pp. 190-4.
Koutroubakis IE, Sfiridaki A, Mouzas IA, et al. Resistance to activated protein C and low levels of free protein S in Greek patients with inflammatory bowel disease. Am J Gastroenterol. 2000;95(1):190-4.
Koutroubakis, I. E., Sfiridaki, A., Mouzas, I. A., Maladaki, A., Kapsoritakis, A., Roussomoustakaki, M., ... Manousos, O. N. (2000). Resistance to activated protein C and low levels of free protein S in Greek patients with inflammatory bowel disease. The American Journal of Gastroenterology, 95(1), pp. 190-4.
Koutroubakis IE, et al. Resistance to Activated Protein C and Low Levels of Free Protein S in Greek Patients With Inflammatory Bowel Disease. Am J Gastroenterol. 2000;95(1):190-4. PubMed PMID: 10638581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resistance to activated protein C and low levels of free protein S in Greek patients with inflammatory bowel disease. AU - Koutroubakis,I E, AU - Sfiridaki,A, AU - Mouzas,I A, AU - Maladaki,A, AU - Kapsoritakis,A, AU - Roussomoustakaki,M, AU - Kouroumalis,E A, AU - Manousos,O N, PY - 2000/1/19/pubmed PY - 2000/1/19/medline PY - 2000/1/19/entrez SP - 190 EP - 4 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 95 IS - 1 N2 - OBJECTIVE: Patients with inflammatory bowel disease (IBD) frequently suffer from thromboembolic events. A recently identified mechanism for thrombophilia, the poor anticoagulant response to activated protein C, has been suggested as one of the leading risk factors for thrombosis. The aim of this study was to evaluate the frequency of thrombophilic abnormalities, including activated protein C-resistance (APCR), in Greek patients with ulcerative colitis (UC) and Crohn's disease (CD). METHODS: Forty-eight patients with UC, 36 with CD, and 61 matched healthy controls (HC) were studied. Cases with presence of lupus anticoagulant, use of anticoagulants or heparin, and pregnancy were excluded. Disease activity in CD was evaluated by use of the Crohns Disease Activity Index (CDAI) score and in UC by the Truelove-Witts grading system. Plasma levels of protein C, free protein S, antithrombin III (AT-III), activated protein C resistance (APCR), and fibrinogen were determined in IBD patients, as well as in HC. All the cases and controls with abnormal APCR were further studied by genetic testing for the factor V Leiden mutation. RESULTS: Mean fibrinogen levels in UC and CD patients were significantly elevated (p<0.0001), compared with HC. The mean values of free protein S, as well as mean APCR, were significantly lower in UC and CD patients than in the HC (p<0.0001). Seven (five UC and two CD) of 84 IBD patients (8.3%) and three of the HC (4.9%) had the factor V Leiden mutation. No significant difference was observed for the other thrombophilic parameters. Fibrinogen levels and profound free protein S deficiency were found related to disease activity. CONCLUSIONS: Thrombophilic defects are common in Greek patients with IBD and they could interfere either in the disease manifestation or in the thrombotic complications. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10638581/Resistance_to_activated_protein_C_and_low_levels_of_free_protein_S_in_Greek_patients_with_inflammatory_bowel_disease_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0002-9270&amp;date=2000&amp;volume=95&amp;issue=1&amp;spage=190 DB - PRIME DP - Unbound Medicine ER -