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P196. Laboratory assessment of inflammation activity in pediatric inflammatory bowel disease

R. Shentova1, E. Panteleeva1, P. Yaneva1, M. Baycheva1, A. Michova2, C. Zhelev1, 1University Pediatric Hospital - Sofia, Gastroenterology and Hepatology, Sofia, Bulgaria, 2Military Medical Academy, Pathomorphology, autopsy and biopsy diagnosis, Sofia, Bulgaria

Background

The aim of this study was to evaluate some laboratory markers of inflammation in pediatric patients with IBD, who have different clinical disease activity and to assess the correlation of those markers with the clinical activity and the endoscopic findings.

Methods

A single center study, including 32 children and adolescents with IBD - 19 with ulcerative colitis (UC) and 13 with Crohn's disease (CD). 21 girls and 11 boys took part in the study. The median age of the participants was 13.6 years. Clinical disease activity was assessed with the validated activity indices in pediatric IBD - Pediatric Ulcerative Colitis Activity Index (PUCAI) and Pediatric Crohn's Disease Assessment Index (PCDAI). All participants provided blood samples for evaluation of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), blood leukocytes and platelets. In addition they provided fresh fecal samples for measurement of fecal calprotectin (FC). FC levels were determined by Bühlman Quantum Blue Reader® and FC values <100 µg/g of stool were considered as normal. All participants in the study underwent a lower endoscopy. Endoscopic findings were assessed according to the Simple Endoscopic Score for Crohn's Disease (SES-CD) and the Mayo endoscopic subscore.

Results

In UC children: Clinical disease activity correlated mostly with leukocytes (r = 0.784), followed by the FC (r = 0.783), platelets (r = 0.745), ESR (0.641) and CRP (r = 0.636). Endoscopic disease activity correlated mostly with FC (r = 0.882), followed by the leukocytes (r = 0.668), platelets (r = 0.642), CRP (r = 0.559) and ESR (r = 0.536). In CD children: Clinical disease activity correlated mostly with CRP (r = 0.556), followed by the ESR (r = 0.553), platelets (r = 0.350), FC (r = 0.328) and leukocytes (r = 0.104). Endoscopic disease activity correlated mostly with FC (r = 0.895), followed by the platelets (r = 0.313), CRP (r = 0.295), leukocytes (r = 0.249) and ESR (r = 0.039). There was a small subgroup of patients in clinical remission who had normal CRP, ESR, blood leukocytes and platelets but elevated FC and positive endoscopic findings.

Conclusion

FC is a useful non-invasive marker that can be used during the follow-up and IBD management in pediatric population.