Occurrence of Thromboembolism in Paediatric Patients With Inflammatory Bowel Disease: Data From the CEDATA-GPGE Registry

Frontiers in Pediatrics

article

Jan De Laffolie¹  Antje Ballauff²  Stefan Wirth²  Carolin Blueml³  Frank Risto Rommel¹  Martin Claßen⁴  Martin Laaß⁵  Thomas Lang⁶  Almuthe Christina Hauer⁷ 

[1]Department of General Pediatrics and Neonatology, University of Giessen

[2]Kinderklinik

[3]Department of Paediatrics, Philipps-University Marburg

[4]Klinikum Links der Weser

[5]Children’s Hospital, Medical Faculty Carl Gustav Carus, Technische Universität Dresden

[6]Kinderklinik Regensburg

[7]Department of Pediatrics and Adolescent Medicine, Medical University of Graz

关键词: IBD;    paediarics;    inflammatory bowel disease;    colitis;    Crohn’s disease;    thromboembolism;    children;   

DOI  :  10.3389/fped.2022.883183

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective Among patients with inflammatory bowel disease (IBD), the risk of thromboembolism (TE) is increased, representing a relevant cause of morbidity and mortality. In contrast to other extraintestinal IBD manifestations, TE receives much less attention because of its low incidence, estimated at merely 0.4–0.9% in hospitalised children with IBD. Methods Cases with TE, as documented in the German-Austrian Paediatric IBD registry gesellschaft für pädiatrische gastroenterologie und ernährung – large paediatric patient registry (CEDATA-GPGE), were analyzed retrospectively. For all patients with signs of TE, a questionnaire was filled in by the treating paediatric gastroenterologist. Results Over 10 years, 4,153 paediatric patients with IBD (0–18 years) were registered in the registry, and 12 of them identified with TE. Eight patients were diagnosed with ulcerative colitis (UC), three with Crohn’s disease (CD), and one with IBD-unclassified. The median age at IBD diagnosis was 10 years and at the manifestation of TE 13 years, respectively, with a median latency to TE of 2 years. Prevalence of TE was 0.3%, with a significantly higher risk for patients with UC than CD (OR 5.9, CI 1.56–22.33, p = 0.008). More girls than boys were affected (f:m = 7:5) without reaching significance. Approximately 90% of patients experienced TE during active disease, with relevant cerebral and limb involvement in 6/12 patients. Various risk factors, e.g., hospitalisation, coagulopathy, or anaemia were identified. TE management included intensive care and surgery. Among the 12 patients, 11 recovered fully, in which one patient has focal epilepsy as a sequela. Conclusion Paediatric patients with IBD have a substantially increased risk for TE. Risk factors, such as those identified should be considered when managing paediatric IBD and preventive measures for those hospitalised taken routinely. Initiating pharmacological thromboprophylaxis is challenging for the lack of published trials on efficacy and safety in paediatric IBD but should be considered carefully in each case.

【 授权许可】

CC BY