DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150234

How does disease location affect acute phase reactants in ulcerative colitis?

Serkan Ipek, Cem Cekic, Emrah Alper, Hulya Yalcin, Burak Toprak, Fatih Aslan, Mahmut Arabul, Belkıs Unsal

Abstract


Background: We aimed to evaluate erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell (WBC), platelet (PLT) counts and albumin levels according to disease location in ulcerative colitis.

Methods: The ESR, CRP, WBC, PLT counts and albumin levels of 206 ulcerative colitis patients with endoscopic activity were retrospectively evaluated. Endoscopic activity had been assessed using Rachmilewitz endoscopic activity index. Patients were grouped according to the extent of disease by Montreal classification, and they were evaluated regarding the location and severity of disease according to the laboratory test results.

Results: Among 206 patients, 88 (42.7%) had extensive colitis, 89 (43.2%) of them had left sided colitis and 29 (14%) patients had proctitis. According to the endoscopic activity index, 32.04% of the patients had mild activity, 39.32% moderate activity and 28.64% had severe activity. As the disease extent progressed from the distal to the proximal intestine, CRP, ESR, WBC and PLT counts showed a significant increase while albumin levels showed a significant decrease. In our study, the test that yielded the best results in the assessment of disease activity was CRP, which was found to be high in 80% of patients with extensive colitis, followed by ESR, PLT and WBC counts. As the involved intestine shortened, the rate of patients with abnormal laboratory tests significantly decreased

Conclusion: CRP, ESR, WBC, PLT counts and albumin levels are of limited value in determining disease activity in ulcerative colitis patients, especially in those with proctitis


Keywords


Acute phase reactants; Ulcerative colitis; CRP

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References


Vilela EG, Torres HO, Martins FP, Ferrari Mde L, Andrade MM, Cunha AS. Evaluation of inflammatory activity in Crohn’s disease and ulcerative colitis. World J Gastroenterol. 2012;18:872-81.

Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 2006;55:426–31.

Langhorst J, Elsenbruch S, Koelzer J, Rueffer A, Michalsen A, Dobos GJ. Noninvasive markers in the assessment of intestinal inflammation in inflammatory bowel diseases: performance of fecal lactoferrin, calprotectin, and PMN-elastase, CRP, and clinical indices. Am J Gastroenterol. 2008;103: 162–69.

Costa F, Mumolo MG, Ceccarelli L, Bellini M, Romano MR, Sterpi C, et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn’s disease. Gut. 2005;54:364–8.

Desai D, Faubion WA, Sandborn WJ. Review article: biological activity markers in inflammatory bowel disease. Aliment Pharmacol Ther. 2007;25:247–55.

Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448–54.

Iskandar HN, Ciorba MA. Biomarkers in inflammatory bowel disease: current practices and recent advances. Transl Res. 2012;159:313-25.

Minderhoud IM, Samsom M, Oldenburg B. What predicts mucosal inflammation in Crohn’s disease patients? Inflamm Bowel Dis. 2007;13:1567–72.

Ricanek P, Brackmann S, Perminow G, Lyckander LG, Sponheim J, Holme O, et al. IBSEN II Study Group. Evaluation of disease activity in IBD at the time of diagnosis by the use of clinical, biochemical, and fecal markers. Scand J Gastroenterol. 2011;46:1081–91.

Schoepfer AM, Beglinger C, Straumann A, Trummler M, Renzulli P, Seibold F. Ulcerative colitis: correlation of the Rachmilewitz endoscopic activity index with fecal calprotectin, clinical activity, C-reactive protein, and blood leukocytes. Inflamm Bowel Dis. 2009;15:1851–8.

Linskens RK, van Bodegraven AA, Schoorl M, Tuynman HA, Bartels P. Predictive value of inflammatory and coagulation parameters in the course of severe ulcerative colitis. Dig Dis Sci. 2001;46:644-8.

Solem CA, Loftus EV, Tremaine WJ, Harmsen WS, Zinsmeister AR, Sandborn WJ. Correlation of C-reactive protein with clinical, endoscopic, histologic and radiographic activity in inflammatory bowel disease. Inflamm Bowel Dis. 2005;11:707–12.

Henriksen M, Jahnsen J, Lygren I, Stray N, Sauar J, Vatn MH, et al. IBSEN Study Group. C-reactive protein: a predictive factor and marker of inflammation in inflammatory bowel disease. Results from a prospective population-based study. Gut. 2008;57:1518–23.

Karoui S, Laz S, Serghini M, Bibani N, Boubaker J, Filali A. Correlation of C-reactive protein with clinical and endoscopic activity in patients with ulcerative colitis. Dig Dis Sci. 2011;56:1801–5.

Lok KH, Ng CH, Hung HG, Li KF, Li KK, Szeto ML. Correlation of serum biomarkers with clinical severity and mucosal inflammation in Chinese ulcerative colitis patients. J Dig Dis. 2008;9:219-24.