Are inherited thrombotic risk factors associated with fibrostenosis in Crohn's disease?
Article first published online: 23 FEB 2011
Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 17, Issue 12, pages 2505–2511, December 2011
How to Cite
Novacek, G., Papay, P., Miehsler, W., Reinisch, W., Lichtenberger, C., Sunder-Plassmann, R., Vogelsang, H., Gratzer, C. and Mannhalter, C. (2011), Are inherited thrombotic risk factors associated with fibrostenosis in Crohn's disease?. Inflamm Bowel Dis, 17: 2505–2511. doi: 10.1002/ibd.21648
- Issue published online: 9 NOV 2011
- Article first published online: 23 FEB 2011
- Manuscript Accepted: 2 JAN 2011
- Manuscript Received: 22 DEC 2010
- thrombotic risk factors;
- surgery for IBD;
Fibrostenotic lesions are common complications in Crohn's disease (CD) often requiring surgery. Inherited thrombotic risk factors are associated with fibrosis in other chronic inflammatory diseases. The aim of the study was to assess whether inherited thrombotic risk factors are associated with fibrostenosis in CD.
Clinical data on 529 CD patients were collected retrospectively. Subjects were tested for and grouped according to the presence of factor V Leiden (FVL), the prothrombin G20210A, and the methylenetetrahydrofolate reductase C677T mutation (MTHFR). Patients who underwent CD-related intestinal surgery were assessed for the presence of fibrostenosis, which was the primary endpoint. The diagnosis of fibrostenosis was based on surgical, pathological, and histopathological reports. A Cox proportional hazards model was used for statistical analysis.
Thirty-two (6.1%, heterozygous 30, homozygous 2) patients were carriers of FVL, 19 (3.6%, all heterozygous) carried the prothrombin variant, and 318 (60.1%) the MTHFR variant (243 heterozygous, 75 homozygous). In all, 303 (57.3%) patients underwent intestinal surgery. Fibrostenosis was identified in 219 (72.3%) surgical specimens. The rate of first intestinal surgeries with fibrostenosis tended to be more frequent in patients with the homozygous 677TT MTHFR mutation (hazard ratio, HR 1.39; 95% confidence interval [CI]: 0.98–1.97; P = 0.067). After adjustment for potential confounders homozygous 677TT MTHFR mutation did not remain a risk factor for intestinal surgery with fibrostenosis (HR 1.23; 95% CI: 0.77–1.98; P = 0.387). FVL and the prothrombin variant had no influence on the primary endpoint.
The MTHFR 677TT mutation, factor V Leiden, and the prothrombin G20210A mutation are not associated with fibrostenosis in CD. (Inflamm Bowel Dis 2011)