Haemorheological and haemostatic alterations in coeliac disease and inflammatory bowel disease in comparison with non-coeliac, non-IBD subjects (HERMES): a case–control study protocol

Szakács, Zsolt; Csiszar, Beata; Kenyeres, Péter; Patrícia, Silvia; Erőss, Bálint; Alizadeh, Hussain; Nagy, Ágnes; Kőszegi, Balázs; Veczák, Ibolya; Farkas, Nelli; Bódis, Emőke; Korbonits, M; Szentesi, Andrea; Tökés-Füzesi, Margit; Berki, Tímea; Vincze, Áron; Tóth, Kálmán; Bajor, Judit

doi:10.1136/bmjopen-2018-026315

Cited by 4 publications

(6 citation statements)

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“…6917) and registered in the ISRCTN Registry under registration number ISRCTN49677481. Full technical details of the protocol are published elsewhere ( 28 ). This report follows the STROBE Statement ( 29 ).…”

Section: Methodsmentioning

confidence: 99%

“…Control subjects were individuals in whom CeD was excluded by the treating gastroenterologist specialist ( 30 , 31 ). Exclusion criteria from the study are detailed in the prestudy protocol ( 28 ).…”

Section: Methodsmentioning

confidence: 99%

“…Laboratory tests were performed from venous blood as detailed in the prestudy protocol ( 28 ). Hemorheology-related terms and measurements are detailed in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

“…Because hemorheological indicators were never determined in CeD, we planned to recruit 100 age- and sex-matched participants (1:1 ratio) in the first phase to determine further target numbers for the second phase ( 28 ). Completing the first phase, we realized that to reach the level of significance for the observed mean differences between patients with CeD and control subjects at α = 0.05 and β = 0.80, we should recruit an unfeasible number of subjects (>1,000 patients for EA indicators, 247 patients for PV, and 289 patients for WBV per group), so that we decided to stop the study for futility.…”

Section: Methodsmentioning

confidence: 99%

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Diet-Dependent and Diet-Independent Hemorheological Alterations in Celiac Disease: A Case-Control Study

Szakács

Csiszar

Nagy

et al. 2020

Clinical and Translational Gastroenterology

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INTRODUCTION: Hemorheology is the study of the flow properties of the blood and its elements, which, together with natural anticoagulants, are important determinants of cardiovascular events. This study aimed to assess hemorheological and natural anticoagulant profiles of patients with celiac disease (CeD) comprehensively. METHODS: Our study is a case-control study (registered under ISRCTN49677481) comparing patients with CeD with age- and sex-matched control subjects (1:1). We measured erythrocyte deformability (ED) at high (3–30 Pa) and low shears (0.3–3 Pa), erythrocyte aggregation, whole blood viscosity, plasma viscosity, and natural anticoagulants (protein C, protein S, and antithrombin activity). Adherence to gluten-free diet was estimated through dietary interview and urine gluten immunogenic peptide (urine GIP) detection. RESULTS: After matching, we analyzed the data of 100 study participants. ED at high shears was impaired in CeD ( P < 0.05 for all shears, confirmed by random forest analysis) independently of findings on CeD-specific serological assessment and urine GIP detection but slightly dependently on dietary adherence ( P = 0.025 for 30 Pa shear). ED at low shears seemed to be impaired only in urine GIP+ CeD patients ( P < 0.05 for all comparisons with urine GIP− CeD patients and control subjects). All parameters describing erythrocyte aggregation and whole blood viscosity were shifted toward a prothrombotic direction in patients with CeD with poor dietary adherence compared with those with good dietary adherence. Plasma viscosity and activity of natural anticoagulants did not differ across groups. DISCUSSION: We observed diet-dependent and diet-independent prothrombotic hemorheological alterations in CeD, which can contribute to the elevated cardiovascular risk. The untoward metabolic changes during gluten-free diet, which can further aggravate hemorheological status, may indicate the implementation of prevention strategies.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Laboratory tests were performed from venous blood as detailed in the prestudy protocol ( 28 ). Hemorheology-related terms and measurements are detailed in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Diet-Dependent and Diet-Independent Hemorheological Alterations in Celiac Disease: A Case-Control Study

Szakács

Csiszar

Nagy

et al. 2020

Clinical and Translational Gastroenterology

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“…Since then, multiple other reports appeared to suggest the connection [ 10 , 11 , 12 ], although various observational studies and meta-analyses have found conflicting results [ 13 , 14 , 15 , 16 , 17 ]. A number of well-designed prospective studies are ongoing in an attempt to understand this association and provide definitive answers [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Celiac Disease and Thrombotic Events: Systematic Review of Published Cases

Pantić¹,

Pantic²,

Jevtic

et al. 2022

Nutrients

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Extraintestinal manifestations of celiac disease (CD) should be considered, even in patients without typical intestinal symptoms. The aim of our study is to examine the literature regarding the occurrence of thrombotic events in CD, and to synthesize the data from case reports and case series. A systematic review of the literature was conducted by searching the Pub-Med/MEDLINE database, from the date of database inception to January 2022, to identify published cases and case series on this topic, in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 55 cases were included in the study. The majority of patients were previously healthy individuals, with no comorbidities. In less than one-third of the cases (30.91%), the diagnosis of CD was established before the onset of thrombosis, while in the remaining cases (34.54%), thrombosis preceded the diagnosis or was diagnosed concomitantly with CD. The most common sites for thrombosis occurrence were hepatic veins (30.91%), while thrombosis of cerebral blood vessels, deep venous thrombosis of lower extremities, and pulmonary thromboembolism were less frequent. Thrombosis was most commonly isolated to one site only (78.18%). In 69.09% of cases (n = 38), some form of anticoagulation, along with a gluten-free diet, was initiated.

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Prevalence of Coagulopathy in Patients with Celiac Disease: A Single-Center Retrospective Case-Control Study

Balaban,

Coman,

Enache

et al. 2023

Gastroenterology Insights

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Introduction: Despite being one of the most frequent chronic digestive diseases worldwide, with a prevalence of 1%, celiac disease (CD) remains severely underdiagnosed. Among the instruments used to improve its diagnostic rate, hematologic parameters have been proposed as screening tests to select patients with an increased probability of having CD. Assessment of coagulation is included in routine check-ups, and CD has been reported to be associated with coagulopathy. We aimed to assess if subtle changes in coagulation tests could be used in clinical practice to prompt testing for CD. Methods: We retrospectively recruited all patients with clinical suspicion for CD during a study period of 7 years (between 2015 and 2022), who were tested using IgA tissue transglutaminase (tTG) serology and serum total IgA (IgG tTG in case of IgA deficiency) and who underwent upper gastrointestinal endoscopy with multiple biopsy sampling of the duodenal bulb and distal duodenum. We stratified patients into three groups: newly diagnosed CD, gluten-free diet-treated CD, and non-CD controls. Results: Altogether, there were 133 CD patients (71 newly diagnosed, 62 GFD-treated) and 57 non-CD controls. Mean age and gender distribution were similar among the three groups: 43.3 years for newly diagnosed CD, 41.6 years for non-CD controls, and 44 years for GFD-treated CD patients, with a male gender distribution of 21.1%, 28%, and 24.1%, respectively. Among the included newly diagnosed CD patients, 14% had a prolonged INR. The mean INR was slightly higher in newly diagnosed CD patients, compared to GFD-treated CD patients and non-CD controls: 1.12 ± 0.30, 1.02 ± 0.83, and 1.00 ± 0.08, respectively (p = 0.009). Consequently, prothrombin activity was slightly lower in newly diagnosed CD patients, compared to GFD-treated CD and non-CD controls: 94.9 ± 19.3%, 102.3 ± 12.8%, and 101.9 ± 15.15, respectively. Interestingly, after GFD, the mean INR and prothrombin activity of CD individuals reached a value similar to that of non-CD controls. Conclusions: Subtle changes in INR, defined as a value within the normal range, but closer to the upper limit, could be an indicator of probability for CD.

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Haemorheological and haemostatic alterations in coeliac disease and inflammatory bowel disease in comparison with non-coeliac, non-IBD subjects (HERMES): a case–control study protocol

Cited by 4 publications

References 59 publications

Diet-Dependent and Diet-Independent Hemorheological Alterations in Celiac Disease: A Case-Control Study

Diet-Dependent and Diet-Independent Hemorheological Alterations in Celiac Disease: A Case-Control Study

Celiac Disease and Thrombotic Events: Systematic Review of Published Cases

Prevalence of Coagulopathy in Patients with Celiac Disease: A Single-Center Retrospective Case-Control Study

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