Thrombotic Risk and Hemostatic Profiles in Pediatric Inflammatory Bowel Disease: Association with Disease Activity

Background/Aims: Inflammatory bowel disease (IBD) increases thromboembolic risk, but pediatric evidence remains limited. The current study evaluated the associations between coagulation markers, systemic inflammation, and disease activity in pediatric IBD and assessed the prevalence of silent thrombosis. Materials and Methods: A total of 46 pediatric patients with IBD were enrolled in this single-center cross-sectional study. All underwent Doppler ultrasonography of the lower extremities and the portal venous system. Hemostatic and inflammatory markers were evaluated in the laboratory and were analyzed in relation to disease activity. Results: One asymptomatic thrombus was detected in a patient with Crohn’s disease (CD). Factor VIII was significantly higher in ulcerative colitis (UC) compared to CD (median 109.5 vs. 74.3 IU/dL, P = .007). In UC, platelet count and D-dimer increased with increasing disease activity and extent. There was a significant relationship between platelet counts and the endoscopic extent (P = .008) and Mayo Score (P = .031). In CD, fibrinogen and factor VIII levels revealed a positive correlation with Pediatric Crohn’s Disease Activity Index scores (P = .012 and P = .040, respectively) but not with the Simple Endoscopic Score. Corticosteroid use was linked to higher factor VII (P = .017). Conclusion: Asymptomatic thrombosis rare in IBD, but inflammation and procoagulant activity were closely related, especially in UC. Platelet count, D-dimer, and factor VIII might serve as biomarkers for thrombotic risk and monitoring. Cite this article as: Ergen YM, Başaran EG, Teke S, .aviş T, Balamtekin N. Thrombotic risk and hemostatic profiles in pediatric inflammatory bowel disease: Association with disease activity. Turk J Gastroenterol. Published online March 24, 2026. doi: 10.5152/ tjg.2026.25541.