engleski

The markers of disease activity in inflammatory bowel disease

BACKGROUND : Chronic inflammatory bowel disease (IBD) encompasses the disease entities, ulcerative colitis (UC) and Crohn s disease (CD). Assessment of disease activity in inflammatory bowel disease is done using clinical and biochemical parameters and various biological disease markers.. AIM : The aim of the present study was to determined the biochemical markers of disease activity in inflammatory bowel disease, and to correlate them with clinical, endoscopic and histological findings. PATIENTS AND METHODS : At intensive care unit Clinical Hospital "MERKUR" in Zagreb, Croatia, during the year 1999, 44 patients (19 men and 25 women, median age 33 yr., range 18- 78 yr.) suffered from inflammatory bowel disease. Of the 44 patients, 24 had Crohn's disease (CD) and 20 had ulcerative colitis (UC). All of patients were followed-up clinically and with laboratory tests: erythrocyte sedimentation rate, leukocyte, CRP, serum electrolyte Na, K, Cl, total calcium, magnesium, phosphate, ammonia, glucose, acid-base, albumin and serum and urinary pancreatic enzymes. All patients had also radiological, endoscopic and histopathologic findings. Patients were divided according age, sex and endoscopic examination. RESULTS: From 44 patients (24 with Crohn's disease and 20 with ulcerative colitis), 26 (59%)patients had left sided colonic disease and 18 (41%) patients had extensive colonic disease. From 26 patients with left side colonic disease, 11 patients (42%) had hyperamylasemia, hypomagnesemia and hypophosphatemia. In group of patients with extensive colonic disease (18 patients), 15 of them (83%) had hyperamilasemia, hypomagnesemia and hypophosphatemia (p< 0, 001). Patients with active disease had higher serum amylase, and lower levels magnesium and phosphate in serum, than patients in remission. CONCLUSION: Our findings suggest that hyperamilasemia, hipomagnesemia and hypophosphatemia accurately reflects the severity of colonic inflammation in patients with Crohn s colitis and ulcerative colitis. The measurements of these parameters seem to be more suitable than other parameters of inflammation, like CRP and ESR. And is very important that these parameters are easily applicable for routine clinical purpose. However, these parameters cannot be used to differentiate between Crohns disease and ulcerative colitis.

DISEASE ACTIVITY; INNFLAMATORY BOWEL DISEASE

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