జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Non-invasive Tests as an Indicator of IBD Activity and Severity

Mohammed Hussien Ahmed, Mohamed Emara and Aya Mohammed Mahrous

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory and destructive disease of the gastrointestinal tract. Chronic inflammation causes ulcerations, stricture formations, and perforations and is a risk factor for dysplasia and cancer. To reduce these longstanding complications, the current treatment goal for patients with IBD is mucosal healing. A treat-to-target approach and close monitoring of disease status improve the
outcomes for these patients. The cornerstone and gold standard for monitoring patients with inflammatory bowel disease is endoscopy, which is time consuming, expensive, and invasive. In addition, pre-procedural bowel
cleansing is uncomfortable and inconvenient. Serological biomarkers, such as ESR, CRP, fecal calprotectin have been widely used as noninvasive parameters for inflammatory bowel disease. in our study we compare the inflammatory bowel disease activity according to Montreal classification which depend upon endoscopy to the level of serological markers as (FC and ESR, Platelet, Total protein, HB level and Albumin) which can be used instead of endoscopy as a marker of activity and the initial level of FC as an Predictor of dysplasia in Ulcerative patient.

Aim: The aim of the study is to (a) determine the mean level of Fecal Calprotectin (FC) at the time of diagnosis and in remission (b) determine the laboratory markers which correlate to IBD activity (c) correlate the initial level of FC as one of predictors for occurrences of early dysplasia. Methods: This prospective study enrolled 96 patients newly diagnosed as inflammatory bowel disease in outpatient clinic at Kafrelsheikh University Hospital after complete clinical and laboratory evaluation followed by endoscopic assessment then histopathological examination and follow up of the patient till clinical remission followed by re-evaluation of the patient.

Results: Ninety-six patients, 78 (81%) ulcerative colitis and 18 (18.8) crohn’s, the mean age about 34.40 years and 30.94 years with p-value 0.380, the mean fecal calprotectin level at the time of diagnosis (823.61+545.457 μg/g)
and after remission 165.18+202.255 μg/g with P-value 0.000.

Conclusion: The mean level of Fecal Calprotectin (FC) at (823.61+545.457 μg/g) at the remission was (165.18+202.255). Fecal Calprotectin, ESR, Platelet, Total protein, HB level and albumin which can be used as a marker of activity. the initial level of FC as an Predictor of dysplasia in ulcerative patient. Presence of parasitic infestation may retard the remission of IBD.