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* = Presenting author

P359 Correlation of simple laboratory tests with clinical disease activity scores in inflammatory bowel disease

O. Tayfur Yurekli, H. Koseoglu, M. Basaran, N.S. Buyukasik, a. Demirezer Bolat, F.E. Akin*, m. Tahtaci, e. Selvi, O. Ersoy

Ankara Ataturk Research and Education Hospital, Gastroenterology, Ankara, Turkey

Background

Inflammatory bowel disease (IBD) follow-up is usually a challenging process. Inflammatory parameters such as erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) usually do not correlate with disease severity in ulcerative colitis (UC). To calculate Mayo score in UC patients, physicians should perform colonoscopy. Likewise calculation of Crohn’s Disease Endoscopic Index of Severity needs ileocolonoscopy. The Crohn’s Disease Activity Index (CDAI) has important limitations in clinical practice because it is subjective and relatively difficult to calculate. Further, CDAI has shown to be poorly correlated with endoscopic disease activity. Mean platelet volume (MPV) and red cell distribution width (RDW) are haematological parameters readily measured with automated complete blood counts. We aimed to show the degree of correlation of these parameters with CDAI and Mayo scores.

Methods

In total, 230 IBD patients who had been followed at Yıldrım Beyazit Faculty of Medicine and who had IBD clinic follow-up between November 2014 and September 2015 were included in this study. Patients’ laboratory data and clinical activity scores were obtained from electronic patient files and IBD charts filled during each visit.

Results

Further, 179 out of 230 IBD patients had been followed with UC (77.8%), and 51 with Crohn’s disease (CD). Mean age of UC patients was 47.89 ± 13.79, whereas in CD patients, mean age was 41.37 ± 12.86. MPV was inversely and RDW was positively correlated with Mayo scores in UC patients.

Table 1. Correlation of routine laboratory tests with Mayo scores in UC patients

Parameterrp
MPV-0.304< 0.001
RDW0.288< 0.001
Haemoglobin-0.503< 0.001
ESR0.507< 0.001
White Blood Cell Count0.1900.011
CRP0.329< 0.001

RDW was also positively correlated with CDAI, whereas MPV lost significance in CD patients.

Table 2. Correlation of routine laboratory tests with CDAI in CD patients

Parameterrp
MPV-0.1550.277
RDW0,2940.036*
Haemoglobin-0,3260.022*
ESR0.566< 0.001
White Blood Cell Count0.1810.205
CRP0.2770.043

Conclusion

Both MPV and RDW are readily measured parameters in automated blood counters. MPV had been reported to be decreased in IBD patients before. MPV had been used in a new scoring system in CD patients, and this scoring system had been defined as the Utrecht Activity Index. On the contrary, RDW has previously been reported to be increased in inflammatory diseases. We found RDW had correlated significantly with clinical activity scores both in UC and CD patients. Considering the difficulties in evaluating IBD patients solely with clinical activity scores we believe that clinicians caring these patients should develop more comprehensive scores based on objective and easily calculated parameters.