Search in the Abstract Database

Abstracts Search 2019

P229 The relationship between computed tomography enterography findings and levels of faecal biomarkers in patients with small bowel Crohn’s disease: A prospective study

T. Shimoyama*1, T. Yamamoto1, S. Umegae1, K. Matsumoto1

1Yokkaichi Hazu Medical Centre, IBD Centre, Yokkaichi, Japan

Background

The value of faecal biomarkers for evaluating small bowel inflammation in patients with Crohn’s disease (CD) remains to be elucidated. This prospective study was designed to assess the relationship between computed tomography enterography (CTE) findings and levels of faecal biomarkers in patients with small bowel Crohn’s disease.

Methods

One hundred twenty-two consecutive patients with a diagnosis of CD in the small intestine were screened for eligibility. CTE was undertaken to evaluate small bowel inflammation followed by colonoscopy to confirm no large bowel involvement. Seventy eligible patients with inflammation confined to the small intestine were included. Faecal samples were collected for assaying calprotectin, lactoferrin and haemoglobin. For assessing the degree of small bowel inflammation, a semi-quantitative scoring system (CTE0, normal; CTE1, mild; CTE2, moderate; CTE3, severe) was applied. The relationship between findings of CTE (the number and locations of lesions, mucosal irregularity and hyperdensity, stenosis, prestenotic dilatation, fistula, target sign, comb sign, and CTE score) and levels of faecal biomarkers.

Results

There was a significant relationship between the levels of faecal biomarkers and almost all of the examined parameters including the number and locations of lesions, mucosal irregularity and hyperdensity, stenosis, prestenotic dilatation, and comb sign. Target sign and fistula were not included in this analysis because only a few patients (n = 2) had positive findings. The median calprotectin, lactoferrin and haemoglobin levels were significantly higher in 42 patients with small bowel inflammation (CTE scores 1–3) than in 28 patients without small bowel inflammation (CTE score 0): Calprotectin, 330 vs. 40 ng/ml, p < 0.0001; lactoferrin, 14 vs. 3 ng/ml, p < 0.0001; haemoglobin, 29.5 vs. 6.5 ng/ml, p = 0.005. There was a significant and positive relationship between the faecal biomarkers and the CTE scores (calprotectin, p < 0.0001; lactoferrin, p < 0.0001; haemoglobin, p = 0.0004).

Conclusion

Faecal calprotectin, lactoferrin and haemoglobin are relevant biomarkers for evaluating small bowel inflammation in CD patients without large bowel involvement.