Assessment of routine laboratory and clinical data for activity of Crohn's disease

Introduction: In inflammatory bowel disease patient's assessment of disease activity is important in order to monitor and adjust therapy. The most used clinical indices for measurement of Crohn's disease activity are complex and time-consuming, therefore their use in clinical practice is limited. No easily usable clinical and sub-clinical markers are currently available to predict relapse during remission.

Aims and methods: The aim of the study was to assess the clinical significance of some routinely available biochemical parameters in Crohn's disease patients classified in subgroups according to Vienna classification comparing to Crohn's Disease Activity Index (CDAI). The serum CRP, fibrinogen, precalcitonin, and thrombocyte count, myeloperoxidase activity index MPXI) was determinated in 24 Crohn's disease patients in active (CDAI³150) and in quiescent (CDAI<150) state. Using simple objective and subjective clinical parameters an easy and routinely applicable evaluation score was developed.

Results: Serum CRP and fibrinogen levels were significantly increased in active disease and show positive correlation with CDAI independently from the disease form. Thrombocyte count was found to be elevated in some patients in active state without any correlation to CDAI, location or behavior of the disease. MPXI values were significantly lower in stricturing form of the disease, showing inverse correlation with the disease activity.

Conclusion: Low myeloperoxidase activity is associated with stricturing form of Crohn's disease indifferent of the localization. This could suggest a subclinical activity of the disease which is not represented by CDAI, but could have importance in therapeutic decisions.