Cerebral vascular events associated with ulcerative colitis in children

Keene, Daniel; Matzinger, Mary Anne; Jacob, Pierre; Humphreys, Peter

doi:10.1016/s0887-8994(00)00264-2

Cited by 32 publications

(25 citation statements)

References 21 publications

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“…Bacterial or viral infections, [3][4][5][6] head or vascular trauma, surgery, immobilization or obesity, 17,22,24,32 jugular 33 or subclavian central venous lines, 7,34,35 solid tumors, leukemia and lymphomas, 8 autoimmune diseases, 9 renal diseases, 10 metabolic disorders, [13][14][15] birth asphyxia, 12 and cardiac malformations were predefined as predisposing clinical conditions. 2 In addition, drugs such as steroids 2,20,22,32 and Escherichia coli asparaginase, the use of sympathomimetics, coagulation factor concentrates, or oral contraceptives, and nicotine abuse were classified as underlying conditions.…”

Section: Underlying Clinical Conditionsmentioning

confidence: 99%

“…1 The disease is serious, and predisposing and influencing factors should be unraveled to identify patients at risk and to establish treatment regimens in children. Local or systemic infections, [3][4][5][6] vascular trauma, 7 cancer, acute lymphoblastic leukemia, drug toxicity, 8 lupus erythematosus, 9 nephrotic syndrome, 10 dehydration, 11 asphyxia, maternal problems during pregnancy, 12 Behçet's disease, 2 and metabolic disorders [13][14][15] have been described as predisposing factors.…”

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confidence: 99%

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Cerebral Venous Thrombosis in Children

et al. 2003

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the Childhood Stroke Study GroupBackground-The present study was performed to assess the association of prothrombotic risk factors and underlying conditions (infections, vascular trauma, immobilization, malignancies, autoimmune diseases, renal diseases, metabolic disorders, obesity, birth asphyxia, cardiac malformations, and use of prothrombotic drugs) with cerebral venous thrombosis (CVT) in children. Methods and Results-From 1995 to 2002, 149 pediatric patients aged newborn to Ͻ18 years (median 6 years) with CVT were consecutively enrolled. In patients and in 149 age-and gender-matched children with similar underlying clinical conditions but without CVT, the factor V G1691A mutation, the factor II G20210A variant, lipoprotein(a) [Lp(a)], protein C, protein S, antithrombin, and antiphospholipid antibodies, as well as associated clinical conditions, were investigated. Eighty-four (56.4%) of the patients had at least 1 prothrombotic risk factor compared with 31 control children (20.8%; PϽ0.0001). In addition, 105 (70.5%) of 149 patients with CVT presented with an underlying predisposing condition. On univariate analysis, factor V, protein C, protein S, and elevated Lp(a) were found to be significantly associated with CVT. However, in multivariate analysis, only the combination of a prothrombotic risk factor with an underlying condition (OR 3.9, 95% CI 1.8 to 8.6), increased Lp(a) (OR 4.1, 95% CI 2.0 to 8.7), and protein C deficiency (OR 11.1, 95% CI 1.2 to 104.4) had independent associations with CVT in the children investigated. Conclusions-CVT in children is

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Section: Underlying Clinical Conditionsmentioning

confidence: 99%

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confidence: 99%

Cerebral Venous Thrombosis in Children

et al. 2003

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“…Chronic inflammation damages the cardiovascular and nervous systems (2,3). Neurological and cardiovascular dysfunctions are the major comorbidities associated with this chronic disease (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Visual evoked potentials and pulse wave velocity in inflammatory bowel disease

Aytaç

Büyüktaş²,

Baysal³

et al. 2015

Turk J Gastroenterol

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Background/Aims: Data about the effects of inflammatory bowel disease (IBD) on various functions of the nervous and cardiovascular systems are limited. In this study, the visual neuronal and cardiovascular functions of patients with IBD were evaluated by measuring visual evoked potentials (VEP) and pulse wave velocity (PWV), respectively. Materials and Methods: There were three study groups: the Crohn's disease (CD) group (n=25), the ulcerative colitis (UC) group (n=30), and a healthy control (C) group (n=25). The exclusion criteria were as follows: patients with IBD were in remission, had no extra-intestinal manifestations of the disease, had no additional chronic disease(s), and had been receiving medical treatment for their IBD without any previous surgical intervention. VEP amplitudes (mV) and the N2 and P2 latencies (ms) were recorded for visual-neuronal analysis of all study groups. For cardiovascular assessment in all study groups, PWV was measured noninvasively as follows: the carotid-femoral PWV with the Complior Colson device (The authors have no conflict of interest.) and the PWV along the aorta with two ultrasound strain-gauge pressure-sensitive transducers (TY-306 Fukuda pressure-sensitive transducers -Fukuda Denshi Co, Tokyo, Japan) fixed transcutaneously over the course of a pair of arteries separated by a known distance. The right femoral and right common carotid arteries were the ones used. Results: The PWV levels of the CD and UC groups were significantly higher than those in the C group (p<0.001). In the bilateral recording of the VEP, the N2 latencies of the CD (p<0.05) and UC (p<0.01) groups were significantly longer than those in the C group. Conclusion: In this study, we showed vascular and visual neuronal impairments at a subclinical stage in patients with both types of IBD.

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“…Although limited data are available in children, there are several reports of arterial strokes in children with IBD. 6,7 Anti-TNF-a therapy itself has been associated with cerebrovascular disease in case reports. Acute cerebral venous sinus thrombosis 8 and systemic and cerebrovascular arterial thromboembolism immediately following initiation of anti-TNF-a therapy in adults are described.…”

Section: Discussionmentioning

confidence: 99%

“…13 Potential mechanisms of arterial ischemic stroke in our patient include arterial thromboembolic disease, local endothelial activation, and vasculitis. 6 Although risk of thromboembolic disease is elevated in IBD, arterial thromboembolic disease in IBD tends to occur in individuals with severe pancolitis who are at high risk for luminal intestinal loss of serum proteins or in patients with recent surgery. 14 Our patient had relatively mild colitis at the time of this event, reflected by his Pediatric Ulcerative Colitis Activity Index score of 30, and his thrombophilia evaluation yielded no incontrovertible evidence of a hypercoagulable state.…”

Section: Discussionmentioning

confidence: 99%