J Pediatr Gastroenterol Nutr. 2022 Feb 4. doi: 10.1097/MPG.0000000000003398.Online ahead of print.

Anna Dilillo ¹, Emanuela Del Giudice, Salvatore Cucchiara, Franca Viola, Saverio Mallardo, Sara Isoldi, Donatella Iorfida, Silvia Bloise, Alessia Marcellino, Vanessa Martucci, Mariateresa Sanseviero, Enrica De Luca, Carmela Protano, Daniela Marotta, Flavia Ventriglia, Riccardo Lubrano

Author information

• ¹Pediatric and Neonatology Unit, Maternal and Child Department, Sapienza University of Rome, Polo Pontino, Latina, Italy Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.

Abstract

Objectives: The occurrence of thrombotic events in adult patients with inflammatory bowel disease (IBD) is linked to multiple interactions between hereditary and acquired risk factors. There are few published data concerning children with IBD. The aim of this study was to investigate the presence of thromboembolic risk factors also in children with IBD.

Methods: We enrolled three groups of children: one with Crohn's disease (CD), one with Ulcerative colitis (UC), and a control group of healthy subjects. For all the partecipants the potential thromboembolic risk was evaluated clinically and with laboratory tests.

Results: We studied: 30 children (25.6%) with CD, 28 (23.9%) with UC, and 59 (50.4%) healthy control subjects. Regarding PCDAI, no significant differences between thromboembolic risk factors and disease activity were detected. Instead, in the patients with UC, stratified with the PUCAI, there was a statistically significant difference in serum fibrinogen levels between patients with mild and moderate/severe disease [3.8 (3.2-4.5) g/L vs 5.7 (4.8-6.2) g/L, p < 0.0032].Serum homocysteine levels were lower in healthy controls than in CD (p = 0.176) and UC (p = 0.026). An increased levels of homocysteine in UC with a homozygous mutation in the MTHFR C677T gene was also observed.

Conclusions: Our study showed that, children with IBD, have clinical features, acquired and congenital factors that can increase thrombotic risk, similarly to adults.