Ulcerative colitis and thrombocytosis: Case report and literature review

Rationale: Ulcerative colitis (UC) is an autoimmune disease of unknown etiology, sometimes associated with anemia and thrombocytosis. Platelets (PLTs) play a role in amplifying inflammatory and immune responses in chronic inflammation. This study discusses the diagnosis and treatment of a case of UC combined with secondary thrombocytosis and reviews the relevant literature. We report an interaction between thrombocytosis and UC to raise clinicians’ awareness of this condition. Patient concerns: In the current report, we discuss the case of a 30-year-old female patient who presented with frequent diarrhea and thrombocytosis. Diagnosis: Severe UC combined with intestinal infection was diagnosed based on colonoscopy and intestinal biopsy. The patient had a PLT count >450 × 109/L and was diagnosed with reactive thrombocytosis. Interventions and outcomes: The patient was discharged from the hospital in remission after receiving vedolizumab and anticoagulant treatment. Lessons: In patients with severe UC with thrombocytosis, clinicians should pay attention to PLTs promoting inflammatory progression, as well as screening for venous thromboembolism risk and prophylactic anti-venous thromboembolism therapy at the time of dosing to avoid adverse effects.

[1]  Zehan Chen,et al.  Interleukin-22 Ameliorates Dextran Sulfate Sodium-Induced Colitis through the Upregulation of lncRNA-UCL to Accelerate Claudin-1 Expression via Sequestering miR-568 in Mice , 2022, Oxidative medicine and cellular longevity.

[2]  X. Chen,et al.  Fecal Microbiota Transplantation Ameliorates Active Ulcerative Colitis by Downregulating Pro-inflammatory Cytokines in Mucosa and Serum , 2022, Frontiers in Microbiology.

[3]  Xudong Tang,et al.  Modified Gegen Qinlian Decoction Regulates Treg/Th17 Balance to Ameliorate DSS-Induced Acute Experimental Colitis in Mice by Altering the Gut Microbiota , 2021, Frontiers in Pharmacology.

[4]  A. Zawada,et al.  Iron Deficiency Anemia in Inflammatory Bowel Diseases—A Narrative Review , 2021, Nutrients.

[5]  B. Larijani,et al.  Association of Dietary Fiber, Fruit, and Vegetable Consumption with Risk of Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. , 2020, Advances in nutrition.

[6]  R. Xu,et al.  Comparative Safety and Effectiveness of Vedolizumab to Tumor Necrosis Factor Antagonist Therapy for Ulcerative Colitis , 2020, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[7]  A. Cifu,et al.  Ulcerative Colitis in Adults. , 2020, JAMA.

[8]  M. Gajewska,et al.  Time-Dependent Indirect Antioxidative Effects of Oat Beta-Glucans on Peripheral Blood Parameters in the Animal Model of Colon Inflammation , 2020, Antioxidants.

[9]  A. Faye,et al.  Venous thromboembolism in inflammatory bowel disease , 2020, World journal of gastroenterology.

[10]  L. Peyrin-Biroulet,et al.  Shedding Light on Hemostasis in Patients With Inflammatory Bowel Diseases. , 2020, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[11]  B. Schroeder,et al.  Microbiota and mucosal defense in IBD: an update , 2019, Expert review of gastroenterology & hepatology.

[12]  C. A. de la Motte,et al.  Platelet Hyaluronidase-2 regulates the early stages of inflammatory disease in colitis. , 2019, Blood.

[13]  D. Granger,et al.  Novel Role for the AnxA1-Fpr2/ALX Signaling Axis as a Key Regulator of Platelet Function to Promote Resolution of Inflammation , 2019, Circulation.

[14]  T. Ramsay,et al.  A clinical predictive model for post‐hospitalisation venous thromboembolism in patients with inflammatory bowel disease , 2019, Alimentary pharmacology & therapeutics.

[15]  S. Miszputen,et al.  Ulcerative colitis - treatment with biologicals. , 2019, Revista da Associacao Medica Brasileira.

[16]  Gang Chen,et al.  HBD Inhibits the Development of Colitis-Associated Cancer in Mice via the IL-6R/STAT3 Signaling Pathway , 2019, International journal of molecular sciences.

[17]  Zhi-xiu Lin,et al.  Self-nanoemulsifying drug delivery system of bruceine D: a new approach for anti-ulcerative colitis , 2018, International journal of nanomedicine.

[18]  M. Holinstat,et al.  Platelet Signaling and Disease: Targeted Therapy for Thrombosis and Other Related Diseases , 2018, Pharmacological Reviews.

[19]  J. Matowicka-Karna.  Markers of inflammation, activation of blood platelets and coagulation disorders in inflammatory bowel diseases. , 2016, Postepy higieny i medycyny doswiadczalnej.

[20]  S. Hutfless,et al.  Adverse Reactions After Intravenous Iron Infusion Among Inflammatory Bowel Disease Patients in the United States, 2010-2014. , 2016, Inflammatory bowel diseases.

[21]  P. Rutgeerts,et al.  The safety of vedolizumab for ulcerative colitis and Crohn's disease , 2016, Gut.

[22]  Jana G Hashash,et al.  Persistent or Recurrent Anemia Is Associated With Severe and Disabling Inflammatory Bowel Disease. , 2015, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[23]  D. Granger,et al.  Hypercoagulability and Platelet Abnormalities in Inflammatory Bowel Disease , 2015, Seminars in Thrombosis & Hemostasis.

[24]  E. Silvestri,et al.  Thrombosis in inflammatory bowel diseases: what’s the link? , 2015, Thrombosis Journal.

[25]  I. Koutroubakis,et al.  Multipotent role of platelets in inflammatory bowel diseases: a clinical approach. , 2014, World journal of gastroenterology.

[26]  A. Griffiths,et al.  Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology. , 2014, Gastroenterology.

[27]  J. Schölmerich,et al.  Extraintestinal manifestations and complications in IBD , 2013, Nature Reviews Gastroenterology &Hepatology.

[28]  P. Rutgeerts,et al.  Vedolizumab as induction and maintenance therapy for ulcerative colitis. , 2013, The New England journal of medicine.

[29]  T. Waldhör,et al.  Iron Deficiency Generates Secondary Thrombocytosis and Platelet Activation in IBD: the Randomized, Controlled ThromboVIT Trial , 2013, Inflammatory bowel diseases.

[30]  R. Evstatiev,et al.  Effect of Iron Therapy on Platelet Counts in Patients with Inflammatory Bowel Disease-Associated Anemia , 2012, PloS one.

[31]  Rebecca L McClarren,et al.  Acute infectious diarrhea. , 2011, Primary care.

[32]  A. Kornbluth,et al.  Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee , 2010, The American Journal of Gastroenterology.

[33]  M. Maher,et al.  Assessment of Thrombophilic Abnormalities During the Active State of Inflammatory Bowel Disease , 2008, Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association.

[34]  S. Pitchford.  Novel uses for anti‐platelet agents as anti‐inflammatory drugs , 2007, British journal of pharmacology.

[35]  F. Bérard,et al.  Arterial thrombosis with anti-phospholipid antibodies induced by infliximab. , 2007, European journal of dermatology : EJD.

[36]  D. Rampton,et al.  Thrombosis and inflammatory bowel disease. , 2005, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[37]  Y. Shoenfeld,et al.  Systemic Thromboembolism in Inflammatory Bowel Disease: Mechanisms and Clinical Applications , 2005, Annals of the New York Academy of Sciences.

[38]  D. Rampton,et al.  Enteric infection in relapse of inflammatory bowel disease: importance of microbiological examination of stool , 2004, European journal of gastroenterology & hepatology.

[39]  W. Sandborn,et al.  Venous Thromboembolism in Inflammatory Bowel Disease , 2004, American Journal of Gastroenterology.

[40]  A. Gasbarrini,et al.  Activated platelets are the source of elevated levels of soluble CD40 ligand in the circulation of inflammatory bowel disease patients , 2003, Gut.

[41]  R. Abbate,et al.  Persistence of hemostatic alterations in patients affected by Crohn's disease after bowel surgery. , 1997, Thrombosis research.

[42]  M. Vitiritti,et al.  Thrombocytosis , 2010, BMC Geriatrics.

[43]  N. Beeching,et al.  The platelet count as a simple measure to distinguish inflammatory bowel disease from infective diarrhoea. , 1991, The Journal of infection.

[44]  S. Truelove,et al.  Cortisone in Ulcerative Colitis , 1954 .