Spontaneous right ventricular thrombus in a patient with active ulcerative colitis and protein C deficiency: a review with a case report

R. Urgesi*,§, C. Zampaletta*, A. Masini*, G. Pelecca*, A. Pastorelli*, A. De Lorenzo§, R. Faggiani*

*Gastroenterology Unit, BelColle Hospital, Viterbo (Italy); §Cattedra di Alimentazione e Nutrizione Umana, Department of Neurosciences, Tor Vergata University, Rome (Italy)

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• Angiology
• Gastroenterology

Abstract. Background: Inflammatory bowel disease (IBD) is an idiopathic condition of gastrointestinal tract whose pathogenesis results from the complex interaction of genetic susceptibility and environmental influences. Is well known how IBD patients have an increased risk of thrombosis.
Objectives: To assess the frequency and characteristics of thromboembolic events (TEE) in IBD and the role of certain etiopathological factors in such thrombotic patients.
Material and Methods: We report the case of a young woman affected by protein C deficiency, who during a clinical recurrence of ulcerative colitis (UC), developed a spontaneous right ventricular thrombus and pulmonary embolism. Then, we made a review of literature that documented thromboembolic events in IBD patients.
Results: A search using the PubMed database identified 65 case reports documenting thromboembolic events in patients with known UC and 7 documenting thromboembolic events in known Crohn’s disease.
Discussion: The data of the literature confirm that IBD patients have an approximately three fold greater risk for developing a TEE compared with the general population. The risk for thrombosis correlates well with disease activity in Crohn’s disease, and to lesser extent in ulcerative colitis.

Corresponding Author: Riccardo Urgesi, MD; e-mail: riurgesi@tin.it

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