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Predictors of acute relapse of Crohn's disease

A laboratory and clinical study

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Abstract

Relapses of Crohn's disease appear to be almost random. If these attacks could be reliably predicted, it might be possible to abort them with early treatment. In order to identify laboratory and clinical parameters that would predict an acute relapse, patients who had been assessed clinically in the three months prior to an attack were studied. Published clinical indices as well as a variety of laboratory parameters were measured. The clinical indices and the serum C-reactive protein, orosomucoid,α 1-antitrypsin, and iron were increased at the time of the attack as compared to three months earlier, while only the clinical indices, orosomucoid andα 1-antitrypsin increased between three months and one month prior to the attack. There was a poor correlation of the parameters to each other. Further prospective studies are needed to determine the specificity of the suggested indices in predicting acute relapses of Crohn's disease.

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References

  1. Best WR, Bectel JM, Singleton JW, Kern F Jr: Development of a Crohn's disease activity index—National Crohn's Disease Study, Gastroenterology 70:439–444, 1976

    Google Scholar 

  2. Andre C, Descos L, Landais P, Fermanian J: Assessment of appropriate laboratory measurements to supplement the Crohn's disease activity index. Gut 22:571–574, 1981

    Google Scholar 

  3. Fagen EA, Dycke RF, Maton PN, Hodgson HJF, Chadwick VS, Petrie A: Serum levels of C-reactive protein in Crohn's disease and ulcerative colitis. Eur J Clin Invest 12:351–359, 1982

    Google Scholar 

  4. Van Hees PAM, van Elteren PN, Van Lier NJJ, van Tongeren JHM: An index of inflammatory activity in patients with Crohn's disease. Gut 21:279–280, 1980

    Google Scholar 

  5. Brown DJC, Khan JAP, Copeland G, Jewell DP: Alpha-2-macroglobulin in patients with inflammatory bowel disease. J Clin Lab Immunol 4:53–57, 1980

    Google Scholar 

  6. Hall JC: Br Med J 286:1895–1896, 1983 (letter)

    Google Scholar 

  7. Lockhart-Mummery HE, Morson BC: Crohn's disease of the large intestine. Gut 5:493–509, 1964

    Google Scholar 

  8. Morson BC: Rectal biopsy in inflammatory bowel disease. N Engl J Med 287:1337–1339, 1972

    Google Scholar 

  9. Babson AL: Phenolphthalein monophosphate. A new substrate for alkaline phosphatase. Clin Chem 11:789, 1965

    Google Scholar 

  10. Batsikas JG, Kremers BJ, Thiessen MT, Shilling JM: Biliary tract enzymology: A clinical comparison of serum alkaline phosphatase, leucine aminopeptidase, and 5-nucleotidase. Clin Pathol 50:485–490, 1968

    Google Scholar 

  11. Fishman WN, Ghosh NK: Isoenzyme of human alkaline phosphatase. Adv Clin Chem 10:255–370, 1967

    Google Scholar 

  12. Green S, Kantor F, Inglis NR, Fishman WH: Normal serum alkaline phosphatase isoenzymes examined by acrylamide and starch gel electrophoresis and by isoenzyme analysis using organ specific inhibitors. Am J Clin Pathol 57:52–64, 1972

    Google Scholar 

  13. Kachmer JF: Enzymes.In Fundamentals of Clinical Chemistry, 2nd ed. NW Tietz (ed). Philadelphia, WB Saunders, 1976; pp 606–608

    Google Scholar 

  14. Newcomb RW, Normansell D, Stanworth DR: A structural study of exocrine IgA globulin. J Immunol 101:905–913, 1968

    Google Scholar 

  15. Kosaka T, Asahina T, Kobayashi N: Different quantification of SIgA and SC by two-directional rocket method. Immunology 40:597–604, 1980

    Google Scholar 

  16. Purves LR, Lindsey CG, Franks JJ: Sites ofd-domain interaction in fibrin derivedd-dimer. Biochemistry 19:4051–4058, 1980

    Google Scholar 

  17. Harries AD, Fitzsimons E, Fifield R, Dew MJ, Rhodes J: Platelet Count: A simple measure of activity in Crohn's disease. Br Med J 286:1476, 1983

    Google Scholar 

  18. Pepys MB: C-reactive protein fifty years on. Lancet 1:1432; 1981

    Google Scholar 

  19. Kindmark CO: Sequential changes in plasma proteins in various acute diseases.In Plasma Protein Turnover. R Bianchi, G Mariani, AS MacFarlane (eds). London, Macmillan Press, 1976, pp 395–402

    Google Scholar 

  20. Amos RS, Constable T, Crockson RA, Crockson AP, McConkey B: Rheumatoid arthritis: Relation of serum C-reactive protein and erythrocyte sedimentation rate to radiographic changes. Br Med J 1:195–197, 1977

    Google Scholar 

  21. Perreira da Silva JA, Elkon K, Hughes GRU, Dyck RF, Pepys MB: CRP levels in systemic lupus erythematosis—a classificable criterion. Arthritis and Rheumatism 23:770–771, 1980

    Google Scholar 

  22. Pepys MB, Druguet M, Klass HJ, Dash AC, Mirjan DD, Petrie A: Immunological studies in inflammatory bowel disease.In Immunology of the Gut J Knight, R Porter (eds). Amsterdam, Excerpta Medica, 1977, pp 283–304

    Google Scholar 

  23. Weeke B, Jarnum S: Serum concentrations of 19 serum proteins in Crohn's disease and ulcerative colitis. Gut 12:297–302, 1971

    Google Scholar 

  24. Beisel WR: Trace elements in infectious processes Med Clin North Am 60:831–849, 1976

    Google Scholar 

  25. Klasen EC, Biemond I, Weterman IT: Alpha-1-Antitrypsin in Crohn's disease in the Netherlands. Gut 21:840–842, 1980

    Google Scholar 

  26. Talstad I, Rootwelt K, Gjone E: Thrombocytosis in ulcerative colitis and Crohn's disease. Scand J Gastroenterol 8:135–138, 1973

    Google Scholar 

  27. Swan CHJ, Williams JA, Cooke WT: Fibrinolysis in colonic disease. Gut 11:588–591, 1970

    Google Scholar 

  28. Kirsner JB, Shorter RG: Recent developments in nonspecific inflammatory bowel disease. N Engl J Med 306:837–848, 1982

    Google Scholar 

  29. Thompson RA, Asquith P, Cooke WT: Secretory IgA in the serum. Lancet 2:517–519, 1969

    Google Scholar 

  30. Meryn S, Lochs H: Diagnostic usefulness of plasma carcinoembryonic antigen (CEA) levels in Crohn's disease. Dig Dis Sci 28:478–479, 1983

    Google Scholar 

  31. Rachmilewitz D, Ligumsky M, Rachmilewitz B, Rachmilewitz M, Tarcic N, Schlesinger M: Transcobalamin II level in peripheral blood monocytes—a biochemical marker in inflammatory diseases of the bowel. Gastroenterology 78:43–46, 1980

    Google Scholar 

  32. Vaitukaitis JL, Ross GT, Braunstein GD, Rayford P: Gonadotrophins and their subunits. Basic and clinical studies. Recent Prog Horm Res 32:289–317, 1976

    Google Scholar 

  33. Kruis W, Mann K: Human chorionic gonadotrophin and alpha chain of glycoprotein hormones in patients with inflammatory bowel disease. Eur J Clin Invest 13:165–169, 1983

    Google Scholar 

  34. Doe WF, Booth CC, Brown DL: Evidence for complement binding immune complexes in adult coeliac disease, Crohn's disease and ulcerative colitis. Lancet 1:402–403, 1973

    Google Scholar 

  35. Hodgson HJF, Potter BJ, Jewell DP: Immune complexes in ulcerative colitis and Crohn's disease. Clin Exp Immunol 29:187–196, 1977

    Google Scholar 

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Authors and Affiliations

  1. Gastrointestinal Clinic, Department of Medicine, University of Cape Town, Observatory 7925, Cape Town, Republic of South Africa

    J. P. Wright MRCP, M. N. Alp FRACP, G. O. Young PhD & N. Tigler-Wybrandi BSc

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  1. J. P. Wright MRCP
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  2. M. N. Alp FRACP
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  3. G. O. Young PhD
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  4. N. Tigler-Wybrandi BSc
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Wright, J.P., Alp, M.N., Young, G.O. et al. Predictors of acute relapse of Crohn's disease. Digest Dis Sci 32, 164–170 (1987). https://doi.org/10.1007/BF01297104

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  • DOI: https://doi.org/10.1007/BF01297104

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