Karim MM, Shaikh H, Ismail FW. Spectrum of venous thromboembolism in adult patients with ulcerative colitis in Pakistan: A single center retrospective study. World J Clin Cases 2025; 13(6): 99648 [DOI: 10.12998/wjcc.v13.i6.99648]
Corresponding Author of This Article
Faisal Wasim Ismail, FACG, FACP, FCPS, MBBS, Associate Professor, Department of Medicine, The Aga Khan University Hospital, National Stadium Road, Karachi 74800, Pakistan. faisal.ismail@aku.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2025; 13(6): 99648 Published online Feb 26, 2025. doi: 10.12998/wjcc.v13.i6.99648
Spectrum of venous thromboembolism in adult patients with ulcerative colitis in Pakistan: A single center retrospective study
Masood Muhammad Karim, Hafsa Shaikh, Faisal Wasim Ismail
Masood Muhammad Karim, Faisal Wasim Ismail, Department of Medicine, The Aga Khan University Hospital, Karachi 74800, Pakistan
Hafsa Shaikh, Department of General Surgery, The Aga Khan University Hospital, Karachi 74800, Pakistan
Author contributions: Karim MM and Shaikh H were responsible for data collection and manuscript writing; Ismail FW was responsible for study conception and manuscript formatting; all the authors have read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of Aga Khan University, Karachi.
Informed consent statement: The need for informed consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Faisal Wasim Ismail, FACG, FACP, FCPS, MBBS, Associate Professor, Department of Medicine, The Aga Khan University Hospital, National Stadium Road, Karachi 74800, Pakistan. faisal.ismail@aku.edu
Received: July 26, 2024 Revised: August 17, 2024 Accepted: September 6, 2024 Published online: February 26, 2025 Processing time: 121 Days and 14 Hours
Abstract
BACKGROUND
Patients with inflammatory bowel disease are at a 2-8-fold higher risk of developing venous thromboembolism (VTE) as compared to the general population. Although the exact pathogenesis is unclear, the literature suggests that increased risk of thromboembolic events in such patients occurs as a result of increased coagulation factors, inflammatory cytokines, and reduction in anticoagulants leading to a prothrombotic state.
AIM
To assess the prevalence, risk factors, management, and outcome of ulcerative colitis (UC) patients who develop VTE.
METHODS
This was a retrospective chart review done in The Gastroenterology Department of The Aga Khan University Hospital. Data was collected from medical records for all patients admitted with a diagnosis of UC from January 2012 to December 2022.
RESULTS
Seventy-four patients fulfilled the inclusion criteria. The mean ± SD of age at presentation of all UC patients was 45 years ± 10 years whereas for those who developed VTE, it was 47.6 years ± 14.7 years. Hypertension and diabetes were the most common co-morbid seen among UC patients with a frequency of 17 (22.9%) and 12 (16.2%), respectively. A total of 5 (6.7%) patients developed VTE. Deep venous thrombosis was the most common thromboembolic phenomenon seen in 3 (60%) patients. All the patients with UC and concomitant VTE were discharged home (5; 100%).
CONCLUSION
The prevalence of VTE with UC in Pakistani patients corresponds with the international literature. However, multi-centric studies are required to further explore these results.
Core Tip: This study highlights the paucity of data available on prevalence of venous thromboembolism in patients with ulcerative colitis (UC) in a low to middle income setting. Although previous studies have shown that patients with acute flare of UC were likely to develop thromboembolism, our data suggests otherwise. Furthermore, this study opens up a new question regarding whether UC is associated with thrombophilic conditions such as protein C deficiency.
