Dr Craig Solem and colleagues examined the relationship between C-reactive protein and clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease (IBD).
The researchers identified IBD patients between 2002 and 2003 who had C-reactive protein, colonoscopy, and either small bowel follow-through or CT enterography within 14 days.
The research team assessed clinical activity retrospectively through review of the medical record.
Logistic regression was used in Crohn's disease patients to estimate the odds ratio with 95% confidence intervals for elevated c-reative protein levels.
The team assessed associations using Fisher exact test in ulcerative colitis patients due to the small sample size.
|Anemia is associated with C-reactive protein elevation in ulcerative colitis patients|
|Inflammatory Bowel Diseases|
The researchers identified 104 patients with Crohn's disease, of which 46% were male, and 43 with ulcerative colitis and indeterminate colitis patients, of which 44% were male.
In patients with Crohn‘s disease, the team found that moderate to severe clinical activity, active disease at colonoscopy, and histologically severe inflammation were all associated with C-reactive protein elevation.
The research team noted that abnormal small bowel radiographic imaging was not significantly associated with C-reactive protein elevation.
In patients with ulcerative colitis, the team observed that C-reactive protein elevation was significantly associated with severe clinical activity, and elevation in sedimentation rate.
The team also noted that anemia, hypoalbuminemia, and active disease at ileocolonoscopy, but not histologic inflammation were associated with C-reactive protein elevation in ulcerative colitis patients.
Dr Solem's team concludes, “C-reactive protein elevation in IBD patients is associated with clinical disease activity, endoscopic inflammation, severely active histologic inflammation specifically in Crohn's disease patients, and several other biomarkers of inflammation, but not with radiographic activity.”