TY - JOUR T1 - Risk of Thrombosis in Sjögren Syndrome: The Open Question of Endothelial Function Immune-mediated Dysregulation JF - The Journal of Rheumatology JO - J Rheumatol SP - 1106 LP - 1108 DO - 10.3899/jrheum.170462 VL - 44 IS - 8 AU - LUCA QUARTUCCIO Y1 - 2017/08/01 UR - http://www.jrheum.org/content/44/8/1106.abstract N2 - Deep vein thrombosis (DVT) and pulmonary embolism (PE) are the 2 common clinical expressions of the vascular phenomenon of venous thromboembolism (VTE). VTE is a common complication during and soon after hospitalization for acute medical illness or surgery1. In Europe, it is estimated to account for 60,000 deaths per year2, and because PE accounts for 5%–10% of deaths in hospitalized patients, VTE is the most common preventable cause of inpatient death1.Historically, Virchow proposed 3 precipitants for venous thrombosis: venous stasis, increased coagulability of the blood, and damage to the vessel wall3.Patients with systemic inflammatory diseases are at high risk for VTE because inflammation is a key determinant of endothelial dysfunction in both arteries and veins, by changing the expression of selectins and cellular adhesion molecules4 and leading to a state of hypercoagulability by influencing clotting factor levels5. Thus, systemic inflammation likely contributes to increasing the risk of VTE in addition to the other known factors, such as age, obesity, immobilization, and malignancy, and it is a possible trigger factor for venous thrombus formation.Indeed, it is well known that an increased serum level of C-reactive protein is an additional risk factor for cardiovascular (CV) events6. In fact, patients with a chronic inflammatory condition, such as those with rheumatoid arthritis (RA) or other chronic inflammatory arthritides, show a higher risk of CV events than the general population7.Importantly, patients having an immune-mediated disease appear at risk of VTE, even independently from a detectable inflammatory state. In fact, in a … Address correspondence to Dr. L. Quartuccio, Clinic of Rheumatology, University of Udine, DAME, Piazzale S. Maria Misericordia 15, 33100 Udine, Italy. E-mail: luca.quartuccio{at}asuiud.sanita.fvg.it ER -