scholarly journals The Role of Portal Vein Thrombosis in the Clinical Course of Inflammatory Bowel Diseases: Report on Three Cases and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Emanuele Sinagra ◽  
Emma Aragona ◽  
Claudia Romano ◽  
Simonetta Maisano ◽  
Ambrogio Orlando ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Inflammatory Bowel Diseases ◽  
Vascular Complications ◽  
Hepatic Abscess ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Thromboembolism Events

Inflammatory bowel diseases are associated with an increased risk of vascular complications. The most important are arterial and venous thromboembolisms, which are considered as specific extraintestinal manifestations of inflammatory bowel diseases. Among venous thromboembolism events, portal vein thrombosis has been described in inflammatory bowel diseases. We report three cases of portal vein thrombosis occurring in patients with active inflammatory bowel disease. In two of them, hepatic abscess was present. Furthermore, we performed a systematic review based on the clinical literature published on this topic.

scholarly journals Portal vein thrombosis in inflammatory bowel diseases: A single-center case series

2012 ◽  
Vol 6 (3) ◽  
pp. 362-367 ◽  
Author(s):  
Giovanni Maconi ◽  
Elena Bolzacchini ◽  
Alessandra Dell'Era ◽  
Umberto Russo ◽  
Sandro Ardizzone ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Inflammatory Bowel Diseases ◽  
Case Series ◽  
Single Center ◽  
Vein Thrombosis ◽  
Bowel Diseases ◽  
Inflammatory Bowel

scholarly journals Pregnancy in a Woman with Latent Myeloproliferative Neoplasm Induced Chronic Portal Vein Thrombosis, Portal Cavernoma, and Gastric Varices

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Andréanne Durivage ◽  
Geneviève Le Templier ◽  
Annabelle Cumyn ◽  
Nadine Sauvé
Keyword(s):  
Portal Hypertension ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Myeloproliferative Neoplasms ◽  
Myeloproliferative Neoplasm ◽  
Vascular Complications ◽  
Breech Presentation ◽  
Gastric Varices ◽  
Vein Thrombosis ◽  
Increased Risk

Extra-hepatic portal vein thrombosis (EHPVO) represents the obstruction of the portal vein outside the liver and is not related to chronic liver disease or neoplasia. In chronic EHPVO, collateral veins and portal hypertension develop, resulting in splenomegaly and variceal formation. Myeloproliferative neoplasms (MPN) are the most frequent acquired etiology of EHPVO. These conditions put pregnant women at increased risk of vascular complications, including venous thrombosis, occlusion of the placental circulation, and variceal bleeding. In this report, we present a 36-year-old pregnant woman with chronic, anticoagulated EHPVO secondary to latent MPN who developed severe intrauterine growth restriction and had cesarean section at 32+1 weeks for increased umbilical doppler resistance and breech presentation. The article will emphasize outcome and management of pregnancies complicated by chronic EHPVO, portal hypertension, and MPN.

scholarly journals Optimization of antenatal monitoring approaches of women with chronic inflammatory bowel diseases

2021 ◽  
pp. 84-92
Author(s):  
O.V. Bulavenko Bulavenko ◽  
D.G. Konkov ◽  
N.V. Kuzminova ◽  
T.V. Lobastova ◽  
I.V. Oleksienko
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Inflammatory Bowel Diseases ◽  
Clinical Guidelines ◽  
Cochrane Library ◽  
Chronic Inflammatory Bowel Diseases ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Chronic Inflammatory Bowel

Chronic inflammatory bowel diseases (CIBD) affect patients at their peak of reproductive age. Clinical presentation of CIBD in pregnancy is associated with an increased risk of adverse effects in mother and fetus, including prematurity, low birth weight, increased indications for caesarean section. Thus optimizing of the CIBD diagnosis and treatment before and during pregnancy is essential to improve maternal and fetal outcomes.Research aim: to analyze the effectiveness of the CIBD clinical management at the stage of preconception and during pregnancy.Materials and methods. It was searched the Cochrane Library, WHO platform, clinical guidelines, and research reference database Medline. All potential studies have evaluated the clinical practice guidelines in women with CIBD for conception, pregnancy and breastfeeding. Recommendations related to the necessary laboratory and instrumental examination methods, therapeutic strategy, the safety of drugs for mother and fetus, the features of multidisciplinary antenatal observation, the timing and method of delivery of pregnant women with CIBD. Results. Treatment in the planning phase and pregnancy should be multidisciplinary, involving a gastroenterologist, obstetrician-gynecologist, primary care physician, pediatrician and a colorectal surgeon if necessary, as well as stakeholders from the association of patients with CIBD. Communication between these professionals is critical to avoid ambivalent or even conflicting counseling, which is an additional source of anxiety for patients, and also potentially dangerous for suboptimal prevention of clinical CIBD manifestation. Obtained results of the analysis will prevent laboratory and therapeutic polypharmacy and significantly improve the pregnancy outcome.Conclusions. Most women with CIBD had a physiological pregnancy and healthy children. However, some studies have linked CIBD to an increased risk of preterm birth and low birth weight infants. The development of national clinical guidelines will optimize and improve the quality of perinatal care to women with CIBD in the Ukraine, and will lead to a decrease in obstetric, fetal and neonatal complications.

scholarly journals Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 753
Author(s):  
Angelica Corrias ◽  
Gian Mario Cortes ◽  
Flaminia Bardanzellu ◽  
Alice Melis ◽  
Vassilios Fanos ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Bacterial Infections ◽  
Immunosuppressive Treatment ◽  
Epidemiological Data ◽  
Adverse Outcomes ◽  
Biologic Drugs ◽  
Angiotensin Converting Enzyme 2 ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases (IBD) are unclear and epidemiological data on the topic are still limited. There is some concern that patients with immuno-mediated diseases such as IBD, which are frequently treated with immunosuppressive therapies, may have an increased risk of SARS-CoV-2 infection with its related serious adverse outcomes, including intensive care unit (ICU) admission and death. Corticosteroids, immunomodulators, and biologic drugs, which are commonly prescribed to these patients, have been associated with higher rates of severe viral and bacterial infections including influenza and pneumonia. It is not known whether these drugs can be so harmful as to justify their interruption during COVID-19 infection or if, on the contrary, patients with IBD can benefit from them. As shown by recent reports, it cannot be excluded that drugs that suppress the immune system can block the characteristic cytokine storm of severe forms of COVID-19 and consequently reduce mortality. Another cause for concern is the up-regulation of angiotensin converting enzyme-2 (ACE2) receptors that has been noticed in these patients, which could facilitate the entry and replication of SARS-CoV-2. The aim of this narrative review is to clarify the susceptibility of SARS-CoV-2 infection in patients with IBD, the clinical characteristics of patients who contract the infection, and the relationship between the severity of COVID-19 and immunosuppressive treatment.

scholarly journals The Natural History, Treatments, and Outcomes of Portal Vein Thrombosis in Patients With Inflammatory Bowel Disease

2020 ◽  
Author(s):  
Leonard Naymagon ◽  
Douglas Tremblay ◽  
Nicole Zubizarreta ◽  
Erin Moshier ◽  
Steven Naymagon ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Bowel Disease ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Cox Proportional Hazards ◽  
Adverse Outcomes ◽  
Vein Thrombosis ◽  
Inflammatory Bowel

Abstract Background Portal vein thrombosis (PVT) is a poorly described complication of inflammatory bowel disease (IBD). We sought to better characterize presentations, compare treatments, and assess outcomes in IBD-related PVT. Methods We conducted a retrospective investigation of IBD-related PVT at our institution. Multivariable Cox proportional hazards modeling was used to estimate adjusted hazard ratios across treatments. Results Sixty-three patients with IBD-related PVT (26 with Crohn disease, 37 with ulcerative colitis) were followed for a median 21 months (interquartile ratio [IQR] = 9-52). Major risk factors included intra-abdominal surgery (60%), IBD flare (33%), and intra-abdominal infection (13%). Primary hematologic thrombophilias were rare and did not impact management. Presentations were generally nonspecific, and diagnosis was incidental. Ninety-two percent of patients (58/63) received anticoagulation (AC), including 23 who received direct oral anticoagulants (DOACs), 22 who received warfarin, and 13 who received enoxaparin. All anticoagulated patients started AC within 3 days of diagnosis. Complete radiographic resolution (CRR) of PVT occurred in 71% of patients. We found that DOACs were associated with higher CRR rates (22/23; 96%) relative to warfarin (12/22; 55%): the hazard ratio of DOACs to warfarin was 4.04 (1.83-8.93; P = 0.0006)). Patients receiving DOACs required shorter courses of AC (median 3.9 months; IQR = 2.7-6.1) than those receiving warfarin (median 8.5 months; IQR = 3.9-NA; P = 0.0190). Incidence of gut ischemia (n = 3), symptomatic portal hypertension (n = 3), major bleeding (n = 4), and death (n = 2) were rare, and no patients receiving DOACs experienced these adverse outcomes. Conclusions We show that early and aggressive use of AC can lead to excellent outcomes in IBD-associated PVT and that DOACs are associated with particularly favorable outcomes in this setting.

scholarly journals Nutrients in the Prevention of Osteoporosis in Patients with Inflammatory Bowel Diseases

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1702
Author(s):  
Alicja Ewa Ratajczak ◽  
Anna Maria Rychter ◽  
Agnieszka Zawada ◽  
Agnieszka Dobrowolska ◽  
Iwona Krela-Kaźmierczak
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Inflammatory Bowel Diseases ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Calcium Phosphorus ◽  
Prevention Of Osteoporosis ◽  
Inflammatory Bowel

The chronic character of inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, results in various complications. One of them is osteoporosis, manifested by low bone mineral density, which leads to an increased risk of fractures. The aetiology of low bone mineral density is multifactorial and includes both diet and nutritional status. Calcium and vitamin D are the most often discussed nutrients with regard to bone mineral density. Moreover, vitamins A, K, C, B12; folic acid; calcium; phosphorus; magnesium; sodium; zinc; copper; and selenium are also involved in the formation of bone mass. Patients suffering from inflammatory bowel diseases frequently consume inadequate amounts of the aforementioned minerals and vitamins or their absorption is disturbed, resulting innutritional deficiency and an increased risk of osteoporosis. Thus, nutritional guidelines for inflammatory bowel disease patients should comprise information concerning the prevention of osteoporosis.

scholarly journals Direct-Acting Oral Anticoagulants (DOACs) in Cirrhosis and Cirrhosis-Associated Portal Vein Thrombosis

2019 ◽  
Vol 39 (02) ◽  
pp. 195-208 ◽  
Author(s):  
Ethan Weinberg ◽  
Julia Palecki ◽  
K. Reddy
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Treatment Guidelines ◽  
Oral Anticoagulants ◽  
Primary Prophylaxis ◽  
Current Treatment ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Direct Acting ◽  
Direct Acting Oral Anticoagulants

AbstractDirect-acting oral anticoagulants (DOACs) have provided benefit in patients requiring anticoagulation for certain diseases by decreasing the burden of subcutaneous injections and the requirement for frequent monitoring through regular blood tests, to ensure adequacy of the therapeutic doses. Studies have demonstrated DOACs to be as safe, and in some instance safer, compared with traditional anticoagulants in the general population. However, the studies evaluating DOACs excluded patients with cirrhosis, a condition associated with an increased risk of developing portal vein thrombosis (PVT). Warfarin or low-molecular weight heparin are the standard-of-care treatment for acute PVT in cirrhosis, although there is enthusiasm in a paradigm shift switching to DOACs for the treatment of acute PVT in cirrhosis, particularly since the release of DOAC antidotes. This article reviews the current Food and Drug Administration-approved DOACs, hepatic metabolism of DOACs, pharmacokinetics of DOACs in patients with cirrhosis, safety of DOACs (including bleeding, hepatotoxicity, and pregnancy), current treatment guidelines for PVT in cirrhosis, and studies evaluating the use of DOACs in cirrhosis and for the treatment of PVT in cirrhosis. The potential use of DOACs for PVT primary prophylaxis in at-risk patients with cirrhosis and the possible antifibrotic effects of DOACs are also discussed.

Increased Risk of Oral Cancer in Patients With Inflammatory Bowel Diseases

2016 ◽  
Vol 14 (3) ◽  
pp. 413-420 ◽  
Author(s):  
Konstantinos H. Katsanos ◽  
Giulia Roda ◽  
Russell B. McBride ◽  
Benjamin Cohen ◽  
Jean-Frédéric Colombel
Keyword(s):  
Oral Cancer ◽  
Inflammatory Bowel Diseases ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Inflammatory Bowel
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