Persistence of hemostatic alterations in patients affected by Crohn's disease after bowel surgery

In Crohn's disease (CD) a condition of hypercoagulability with increased risk for thrombotic events has been reported. In this study we have investigated hemostatic parameters in thirty-one patients affected by CD before, 3 and 12 months after bowel operation, and in thirty healthy controls. Before surgery platelet number (PLT), fibrinogen (Fbg), prothrombin fragment F1+2 (F1+2), PAI and whole blood-spontaneous platelet aggregation (WE-SPA) were significantly higher (p at least <0.0005) in patients than in controls, while factor XIII (F XIII) was significantly lower (p at least <0.005). Three and twelve months after surgery PLT, FBG and WE-SPA significantly decreased in comparison to pre-surgery values (respectively p at least <0.05 and p<0.01), but PLT and Fbg were still significantly higher than in controls at 3 and 12 months (p<0.01). At three and 12 months after operation F XIII was significantly higher in comparison with pre-surgery values (p at least <0.05). The presence of antiphospholipid antibodies (aPL) was not different between CD patients and controls before surgery, whereas it significantly increased 12 months after surgery (p<0.05). Our results suggest that in CD hemostatic changes are only in part influenced by local flogistic processes and that an inflammatory systemic condition may provoke both the bowel and extraintestinal manifestations of CD. (C) 1997 Elsevier Science Ltd.