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[成人乳糜泻伴血栓形成:7例病例系列。血栓形成倾向因素的作用]

[Adult celiac disease with thrombosis: a case series of seven patients. Role of thrombophilic factors].

作者信息

Berthoux E, Fabien N, Chayvialle J-A, Ninet J, Durieu I

机构信息

Service de médecine interne, centre hospitalier Lyon Sud, hospices civils de Lyon, 69495 Pierre-Bénite, France.

出版信息

Rev Med Interne. 2011 Oct;32(10):600-4. doi: 10.1016/j.revmed.2011.02.025. Epub 2011 Mar 24.

Abstract

PURPOSE

Thrombotic events may occur in celiac disease. In this study, we analyzed clinical features and risk factors for thrombosis in seven patients who had celiac disease and thrombosis.

METHODS

We retrospectively studied 87 patients with adult celiac disease and identified seven cases of thrombosis. We searched if risk factors for thrombosis were identified and tested retrospectively antiphospholipid antibodies on the serum.

RESULTS

In our study, the global prevalence of thrombosis was 8 %, and 5.7 % for spontaneous thrombosis, with venous thrombosis (n=5) or arterial thrombosis (n=1) or both (n=2). The seven patients consisted in six women and one man with a mean age of 44.8 years at time of thrombosis. Thrombotic events occurred before the diagnosis of celiac disease in four cases. In three cases, venous thrombosis was in unusual sites: portal (n=2), splenic vein thrombosis (n=1). In six cases, we identified risk factors for thrombosis, which could be linked to celiac disease: hyperhomocysteinemia (n=1), protein C and S deficiency due to vitamin K deficiency (n=3) and antiphospholipid antibodies (n=2).

CONCLUSION

Such risk factors for thrombosis should be identified in patients in adult celiac disease in order to correct them and add a thromboembolic prophylaxis.

摘要

目的

乳糜泻患者可能发生血栓形成事件。在本研究中,我们分析了7例患有乳糜泻并发生血栓形成的患者的临床特征和血栓形成的危险因素。

方法

我们回顾性研究了87例成年乳糜泻患者,确定了7例血栓形成病例。我们检查是否确定了血栓形成的危险因素,并对血清进行回顾性抗磷脂抗体检测。

结果

在我们的研究中,血栓形成的总体患病率为8%,自发性血栓形成的患病率为5.7%,包括静脉血栓形成(n = 5)、动脉血栓形成(n = 1)或两者皆有(n = 2)。这7例患者包括6名女性和1名男性,血栓形成时的平均年龄为44.8岁。4例血栓形成事件发生在乳糜泻诊断之前。3例患者的静脉血栓形成部位不常见:门静脉(n = 2)、脾静脉血栓形成(n = 1)。6例患者中,我们确定了可能与乳糜泻相关的血栓形成危险因素:高同型半胱氨酸血症(n = 1)、维生素K缺乏导致的蛋白C和S缺乏(n = 3)以及抗磷脂抗体(n = 2)。

结论

成年乳糜泻患者应确定此类血栓形成危险因素,以便进行纠正并增加血栓栓塞预防措施。

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