Biological and Histological Parameters As Predictors of Relapse in Ulcerative Colitis: a Prospective Study

Overview

Journal Saudi J Gastroenterol

Specialty Gastroenterology

Date 2011 May 7

PMID 21546723

Citations 32

Authors

Sheenam Azad

Neena Sood

Ajit Sood

Affiliations

Soon will be listed here.

Abstract

Background/aim: Ulcerative colitis is a chronic inflammatory disease of unknown etiology characterized by periods of remission and relapses. This study has been carried out in a group of North Indian patients, where the disease has shown an increasing prevalence and frequent relapses. Hence, there is a need to predict relapse for better management and to reduce morbidity. To assess the importance of biological and histological parameters in predicting relapse when the disease is in quiescent phase.

Materials And Methods: A prospective study of twenty-six patients with quiescent ulcerative colitis was carried out in Dayanand Medical College and Hospital,Punjab. Only patients with clinical and endoscopic remission at the time of screening visit were included. Hemoglobin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum Interleukin-6 (IL-6) levels were measured. The baseline colonoscopic mucosal biopsies were retrieved and studied. Follow-up was conducted for one year at monthly interval or earlier if relapse occurred.

Results: Fifteen out of twenty-six patients (57.69%) had evidence of clinical relapse during the follow-up. Hemoglobin, ESR, CRP and IL-6 levels were not found to be significant predictors of relapse. Increased number of eosinophils and neutrophils in the lamina propria were observed to be associated with significantly higher relapse rate.

Conclusion: A higher risk of relapse in patients with quiescent colitis can be predicted by the presence of increased number of eosinophils and neutrophils in the lamina propria.

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References

Bitton A, Peppercorn M, Antonioli D, Niles J, Shah S, Bousvaros A . Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis. Gastroenterology. 2001; 120(1):13-20. DOI: 10.1053/gast.2001.20912. View

Leo S, Leandro G, Di Matteo G, Caruso M, Lorusso D . Ulcerative colitis in remission: it is possible to predict the risk of relapse?. Digestion. 1989; 44(4):217-21. DOI: 10.1159/000199914. View

Schumacher G, Sandstedt B, Kollberg B . A prospective study of first attacks of inflammatory bowel disease and infectious colitis. Clinical findings and early diagnosis. Scand J Gastroenterol. 1994; 29(3):265-74. DOI: 10.3109/00365529409090475. View

Buckell N, Lennard-Jones J, Hernandez M, Kohn J, Riches P, Wadsworth J . Measurement of serum proteins during attacks of ulcerative colitis as a guide to patient management. Gut. 1979; 20(1):22-7. PMC: 1418967. DOI: 10.1136/gut.20.1.22. View

Kishimoto T . The biology of interleukin-6. Blood. 1989; 74(1):1-10. View

Surawicz C, Haggitt R, Husseman M, McFarland L . Mucosal biopsy diagnosis of colitis: acute self-limited colitis and idiopathic inflammatory bowel disease. Gastroenterology. 1994; 107(3):755-63. DOI: 10.1016/0016-5085(94)90124-4. View

Sood A, Midha V, Sood N, Bhatia A, Avasthi G . Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut. 2003; 52(11):1587-90. PMC: 1773859. DOI: 10.1136/gut.52.11.1587. View

Holtkamp W, Stollberg T, Reis H . Serum interleukin-6 is related to disease activity but not disease specificity in inflammatory bowel disease. J Clin Gastroenterol. 1995; 20(2):123-6. DOI: 10.1097/00004836-199503000-00010. View

Riley S, Mani V, GOODMAN M, Dutt S, Herd M . Microscopic activity in ulcerative colitis: what does it mean?. Gut. 1991; 32(2):174-8. PMC: 1378803. DOI: 10.1136/gut.32.2.174. View

10.

Backmerhoff F, Schumacher B, Niederau C . Inflammatory mediators and acute phase proteins in patients with Crohn's disease and ulcerative colitis. Hepatogastroenterology. 1997; 44(13):90-107. View

11.

Fochios S, Korelitz B . The role of sigmoidoscopy and rectal biopsy in diagnosis and management of inflammatory bowel disease: personal experience. Am J Gastroenterol. 1988; 83(2):114-9. View

12.

Moum B, Ekbom A, Vatn M, Aadland E, Sauar J, Lygren I . Clinical course during the 1st year after diagnosis in ulcerative colitis and Crohn's disease. Results of a large, prospective population-based study in southeastern Norway, 1990-93. Scand J Gastroenterol. 1997; 32(10):1005-12. DOI: 10.3109/00365529709011217. View

13.

Tracey K, Vlassara H, Cerami A . Cachectin/tumour necrosis factor. Lancet. 1989; 1(8647):1122-6. DOI: 10.1016/s0140-6736(89)92394-5. View

14.

Whelan G . Epidemiology of inflammatory bowel disease. Med Clin North Am. 1990; 74(1):1-12. DOI: 10.1016/s0025-7125(16)30581-8. View

15.

Surawicz C, Belic L . Rectal biopsy helps to distinguish acute self-limited colitis from idiopathic inflammatory bowel disease. Gastroenterology. 1984; 86(1):104-13. View

16.

Riley S, Mani V, GOODMAN M, Lucas S . Why do patients with ulcerative colitis relapse?. Gut. 1990; 31(2):179-83. PMC: 1378376. DOI: 10.1136/gut.31.2.179. View

17.

Wright R, Truelove S . Serial rectal biopsy in ulcerative colitis during the course of a controlled therapeutic trial of various diets. Am J Dig Dis. 1966; 11(11):847-57. DOI: 10.1007/BF02233941. View

18.

Geboes K, Riddell R, Ost A, Jensfelt B, Persson T, Lofberg R . A reproducible grading scale for histological assessment of inflammation in ulcerative colitis. Gut. 2000; 47(3):404-9. PMC: 1728046. DOI: 10.1136/gut.47.3.404. View