Connective tissue inflammation may pose VTE risk
MedWire News: Patients with autoimmune conditions affecting connective tissue have an increased risk for venous thromboembolism (VTE) in the months after diagnosis, say Danish researchers who found the extent of risk varied with diagnosis.
The team from Aarhus University Hospital identified a particularly high rate among children with juvenile rheumatoid arthritis (JRA) and patients with systemic lupus erythematosus (SLE).
Sigrun Johannesdottir and co-workers explain in the Journal of Thrombosis and Haemostasis that systemic inflammation is associated with blood vessel damage and alteration of the coagulation and fibrinolysis pathways.
For their study, they examined medical records over a 10-year period for 14,721 patients with VTE and 147,210 age-, gender-, and county-matched individuals without thrombosis for a hospital diagnosis of autoimmune diseases affecting skin or connective tissue.
The researchers found no correlation between hospitalization for autoimmune skin disorders, such as atopic dermatitis, pemphigoid or psoriasis, and the risk for VTE, after adjusting for confounding factors such as comorbidity and medication use.
Patients who had been hospitalized for connective tissue disease, including rheumatoid arthritis, SLE, systemic sclerosis, and ankylosing spondylitis, were 2.3 times more likely to experience VTE in the 90 days following diagnosis than controls.
However, the increased risk for VTE in connective tissue disease patients did not continue after this point. This pattern may support a causative role for inflammation in the risk for VTE, as patients newly diagnosed with connective tissue disease may have elevated inflammatory activity, the researchers suggest.
Analysis of individual diseases showed that patients with JRA and SLE were a significant 3.0 and 2.8 times more likely to have VTE than controls, and their increased risk for thrombosis was sustained at 1 year past diagnosis.
"Autoimmune diseases differ with regard to the severity of systemic inflammation and the antigenic potential of specific tissue components," the authors conclude. "Involvement of the vasculature might therefore vary between the diseases, which could explain part of the variation that we found."
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By Lynda Williams