Share Facebook
Crohn's Disease Forum » Parents of Kids with IBD » Children and Inflammation markers


 
04-07-2013, 12:42 AM   #91
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Never heard of an INR (International Normalised Ratio) being used as an inflammatory marker for Crohn's. My first thought was what you are alluding to Tess...people in a flare tend to have 'sticky' blood so are they saying that you should have an increased prothrombin (clotting) time if you are flaring? Again, I have never heard of an INR being used in this context.
If there is bleeding associated with inflammation then platelets could also be an indicator of active disease.

Perhaps the liver aspects of things has to with Vitamin K and its role in blood clotting. Vit K is stored in the liver.

Dusty.
04-07-2013, 02:36 AM   #92
CarolinAlaska
Holding It Together
 
CarolinAlaska's Avatar
 
Join Date: Jan 2013
Location: North Central, Illinois

My Support Groups:
Do any of your GIs test for INR? A couple of days ago, my friend (daughter with crohns), asked how we would monitor Stephen's remicade 'improvement' given his lack of apparent symptoms... she mentioned that her daughter has her INR checked regularly and that, in her case, it indicates continued inflammation.

WHAT??? How is it that there is a test for inflammation that I haven't heard of?!?!? Needless to say, I'm sure you can all imagine what I've done since...

So, (and bear with me as this is still new to me... so, my explanation may be a bit sketchy) what I've learned is that inflammation activates a blood clotting response, blood clotting agents in your body are then 'used up' clotting, at this point, when blood clotting is necessary, it takes longer to clot because the clotting agents have already been used up. My understanding is that INR tests the length of time for your blood to clot. (Hope that made sense, and remember, may not be 100% accurate.) My friend says this is tested each time her daughter has remicade and it is an indication the doctors are using to determine active inflammation. (INR is also an indicator of liver function but I'm not sure how...).

I posted a much better explanation on a blood clotting thread I'd seen earlier...
http://www.crohnsforum.com/showthread.php?t=47740 (post #22)

So, I'm just curious... Have your kids had their INR levels (or sometimes referred to as PT) tested? Have you ever heard that this is a reliable test/indicator of inflammation?
Can inflammation cause clotting? My husband has a clotting disorder (Factor V Leiden deficiency). I don't remember if Jaedyn has ever been checked for this. So, now I'm wondering if she is at increased risk for clotting as a Crohn's patient, and should I be pushing for her to be tested?

Dusty, I do know that elevated platelets on a CBC could indicate inflammation.
__________________
Carol
J's story: http://apathnotchosen.blogspot.com
*J, 18, Crohn's diagnosis 1-2013 (age13), controlled with 6MP.
Osteoporosis, Scoliosis, EDS, Asthma, Lymphedema, Epilepsy, Hla B-27 positive, gluten intolerant, thrombophlebitis, c.diff, depression, anxiety postural tachycardia/POTS and multiple food allergies.
04-07-2013, 03:41 AM   #93
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Hey Carol,

Crohn's has been associated with an increased risk of blood clots...

http://www.webmd.com/ibd-crohns-dise...ises-clot-risk

...I think it would be worth having J tested so you know where you stand in regard to an even higher clotting risk, plus being female there is the possible use of contraceptives in the future.

Dusty. xxx
04-07-2013, 08:49 AM   #94
Tesscorm
Moderator
 
Tesscorm's Avatar
 
Join Date: Jun 2011
Location: Ontario

My Support Groups:
Thanks Dusty. I've read a bit on this now but something is still confusing me??? So, inflammation caused 'sticky' blood and, according to the link I posted, due to the excessive 'clotting' the blood is left with few clotting agents, resulting in longer clotting time and the risk of bleeding. PT/INR tests this 'time'. But, if blood is 'sticky', wouldn't it clot easier? Why would sticky blood take longer to clot? Is it simply because there is a lack of clotting agents to make the sticky blood clot?
__________________
Tess, mom to S, 22
Diagnosed May 2011

Treatment:
May-July 2011 - 6 wks Exclusive EN via NG tube - 2000 ml/night, 1 wk IV Flagyl
July 2011-July 2013 - Supplemental EN via NG, 1000 ml/night, 5 nites/wk, Nexium, 40 mg
Feb. 2013-present - Remicade, 5 mg/kg every 6 wks
Supplements: 1-2 Boost shakes, D3 - 2000 IUs, Krill Oil
04-07-2013, 09:22 AM   #95
my little penguin
Forum Monitor
 
Join Date: Apr 2012

My Support Groups:
Can inflammation cause clotting? My husband has a clotting disorder (Factor V Leiden deficiency). I don't remember if Jaedyn has ever been checked for this. So, now I'm wondering if she is at increased risk for clotting as a Crohn's patient, and should I be pushing for her to be tested?

Dusty, I do know that elevated platelets on a CBC could indicate inflammation.
Carol
when Ds had vasculitis -clotting disorders were brought up and tested for solely because he had crohn's for the same"sticky" blood reason.
__________________
DS - -Crohn's -Stelara
04-07-2013, 03:23 PM   #96
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
Thanks Dusty. I've read a bit on this now but something is still confusing me??? So, inflammation caused 'sticky' blood and, according to the link I posted, due to the excessive 'clotting' the blood is left with few clotting agents, resulting in longer clotting time and the risk of bleeding. PT/INR tests this 'time'. But, if blood is 'sticky', wouldn't it clot easier? Why would sticky blood take longer to clot? Is it simply because there is a lack of clotting agents to make the sticky blood clot?
The link you have posted Tess is referring to systemic inflammation, so a more severe condition than inflammation that is confined to the bowel, joints etc. In the case of systemic inflammation I can see that the demands placed on the body would overwhelm the coagulation system and cause the opposite effect by depleting its agents.

In IBD though the demands aren't as great. The inflammation that is present is creating enough pressure that extra platelets and clotting agents are required but not enough to deplete supplies. The issue is also that is a chronic problem and hence the blood becomes 'sticky' and increases the risk of clots.

I hope that makes sense!

Dusty. xxx
04-07-2013, 06:35 PM   #97
Tesscorm
Moderator
 
Tesscorm's Avatar
 
Join Date: Jun 2011
Location: Ontario

My Support Groups:
Makes sense. Thanks Dusty.

I wonder why my friend's GI refers to this test as an indication of inflammation (she said they refer to it quite regularly). Does seem to give an indication but a bit 'indirectly'??? Perhaps all her other labs are normal... will ask her, would be interesting to know if, as all other labs are normal, GI has looked to INR?? (One more question for Stephen's poor GI! )
04-07-2013, 08:18 PM   #98
kimmidwife
Forum Monitor
 
kimmidwife's Avatar
we also never had this checked Tess. But I am wondering if she was referring to all the tests together as tests for inflammation and did not specifically mean that one
__________________

Crohn's Dx'ed Sept 08
Allerg Imuran Sept 08
Fail Remicade Jan 09
Methotrex Oct 09-Aug 11
Pentasa stopped - nosebleeds
EENOct 31 - Nov 28th. Too hard!
Retried Remicade Dec 11
Stopped due 2 Anaphylactic Reaction
LDN Jan 2012-June 2014 Got My daughter back!
New secondary diagnosis: Gastroporesis Dec 2013
Lost remission June 2014
Started Entyvio April 2015. Decreased to every 4 weeks October 2015. Praying for remission.
04-07-2013, 09:16 PM   #99
DustyKat
Super Moderator
 
DustyKat's Avatar
 
Join Date: May 2010
Location: New South Wales, Australia
I would be interested to know too Tess as it would appear to me to be a quite indirect link at best. If other tests are normal I can't see how an INR would pick up what an ESR or CRP or FC or FOB wouldn't.

This is an intetresting overview of inflammation and coagulation if you are interested, it includes the role of INR, PT, ESR and CRP:

http://www.lhsc.on.ca/Health_Profess...flam_04_06.pdf

Dusty.
04-07-2013, 09:26 PM   #100
Tesscorm
Moderator
 
Tesscorm's Avatar
 
Join Date: Jun 2011
Location: Ontario

My Support Groups:
No, Kim. We were discussing how Stephens almost all of Stephens labs were good bfr starting remicade, so what wud the GI use to determine efficacy. She then asked how Stephens INR was, when I said I'd never even heard of that, she was allso surprised and said her daughter has it tested bfr every remi infusion and that her GI, more than once, has said that altho she looks and feels good, INR is still indicating inflammation. She's also on Metho so liver function might be playing a role in why the test is run but she's never had any liver problems. Strange, eh? I am quite curious now how and why its used! I've tried to do a bit more research but hvnt found anything with a direct connection btwn INR and crohns-specific inflammation.

Its also coincidental as, ever since I read that other thread abt blood clots, I did have 'clots' as something I was going to ask the GI about (if I had time)... Not something I think is overly concerning but no harm in asking...

Only brought all this up here bcz we were discussing inflammation markers...
04-07-2013, 09:29 PM   #101
Tesscorm
Moderator
 
Tesscorm's Avatar
 
Join Date: Jun 2011
Location: Ontario

My Support Groups:
Dusty, I will post what the gi says...
Reply

Crohn's Disease Forum » Parents of Kids with IBD » Children and Inflammation markers
Thread Tools


All times are GMT -5. The time now is 04:25 AM.
Copyright 2006-2017 Crohnsforum.com