Assessment of anti-prothrombin antibodies in thrombosis complicating inflammatory bowel diseases.

PURPOSE: In inflammatory bowel diseases (IBD), risk of thrombosis and production of antibodies are increased. In autoimmune and inflammatory disorders, a role of anti-prothrombin (aPT) antibodies in developing thrombosis has been hypothesised. The aim of the study is to evaluate the prevalence of aPT antibodies in IBD patients, with and without thrombosis. METHODS: Thirty-three IBD patients with thrombosis, 33 IBD patients without thrombosis matched for sex, age, diagnosis and disease activity and 66 sex- and age-matched healthy controls were enrolled. Thrombosis was considered recent when blood sample was obtained within 3 months from the event. RESULTS: Prevalence of aPT antibodies in thrombotic IBD patients (3/33, 9.1 %), non-thrombotic IBD patients (4/33, 12.1 %) and in healthy subjects (3/66, 4.5 %) did not result significantly different (p = 0.377). The prevalence of aPT antibodies was more frequent in ulcerative colitis (6/32, 18.7 %) than in Crohn's disease (1/34, 2.9 %) and healthy controls (p = 0.022). Among thrombotic IBD patients, the prevalence of aPT antibodies was higher in those with recent (2/9, 22.2 %) than in those with previous thrombosis (1/24, 4.2 %) (p = 0.103). All thrombotic IBD patients with aPT antibodies were affected by ulcerative colitis with previous history of deep venous thrombosis. CONCLUSIONS: aPT antibodies do not appear to play a relevant role in thrombosis complicating IBD course. A possible association in ulcerative colitis patients with DVT could not be excluded.

[Smoking and Crohn's disease: cessation strategies]. / Tabaquismo y enfermedad de Crohn: estrategias de deshabituación.

Smoking is a chronic disease that causes a wide variety of health problems, especially respiratory and cardiovascular diseases. Tobacco smoking is the main environmental factor linked to the pathogenesis and clinical course of Crohn's disease. However, smoking cessation is often not included as part of the treatment of this disease. In the last decade, major advances have been made in our understanding of the physiopathology and treatment of nicotine addiction. Several medical resources are currently available, ranging from a brief warning in the consulting room out patient clinic to drug therapies aimed at nicotine receptors to achieve smoking cessation. Gastroenterologists should provide firm medical advice and evaluate the need for adjuvant treatments to achieve smoking cessation in patients with Crohn's disease.