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P305 Platelet parameters evaluation as a non-invasive marker of inflammation in Crohn’s disease

M. Padysz*1, J. Banasik1, A. Gąsiorowska1

1Military Medical Academy Memorial Teaching Hospital of the Medical University of Lodz – Central Veterans’ Hospital, Department of Gastroenterology, Lodz, Poland

Background

Immunological disturbances play a crucial role in the pathogenesis of Crohn’s disease (CD) by leading to inflammation of the intestinal mucosa. Blood clotting disorders accompany this inflammation and reinforce it by a positive feedback loop. Platelets (PLT) are important key regulators in inflammatory disorders beyond haemostasis and thrombosis. Aim of this study was to assess if platelet parameters, may be used as a non-invasive marker for monitoring disease activity in CD patients.

Methods

In total, 100 patients with diagnosed CD were enrolled in the study (W50/M50) at the mean age of 33.5 years hospitalised at Department of Gastroenterology, Medical University of Lodz with different clinical course, disease location and a heterogeneous therapy. The clinical state of each patient was classified according to Harvey–Bradshaw index (H-B). In all patients, venous blood samples were drawn for assessment of CRP, Fe, blood count and the stool sample was taken for faecal calprotectin evaluation. The results were analysed by dividing patients into two groups - exacerbation and remission considering the calprotectin level >200 or the H-B ratio ≥5.

Results

In the entire study group, positive correlation was found between calprotectin and platelet parameters: PLT, PCT, and negative correlation between calprotectin and MPV (Table 1).

Similarly, a positive correlation was found between H-B and PLT and PCT, and no correlation with MPV was found. Then, the correlation between the parameters and calprotectin was rated in two groups - exacerbation and remission. In the analysis of patients with exacerbation, statistically significant results with all platelet parameters were found in the group with H-B index above 5. Also CRP, Hgb, Fe correlated with H-B index, no correlation with WBC was found. In the group with calprotectin >200-PLT (p = 0.048) and MPV (p = 0.029) correlated with the calprotectin level, there was no correlation with PCT. Among patients in the period of exacerbation, the correlation of calprotectin with the most frequently determined inflammatory parameters, CRP and WBC, has not been demonstrated. There were no correlations between platelet parameters in the group of patients in remission (Table 2).

Conclusion

Our study showed that level of platelets is a useful, non-invasive, inexpensive, and underestimated method for monitoring inflammation in CD.