Relationship between intestinal permeability to [51Cr]EDTA and inflammatory activity in asymptomatic patients with Crohn's disease.
The relationship between intestinal permeability to an oral dose (100 mu Ci) of [51CR]EDTA and the inflammatory activity of Crohn's disease was studied in 63 adult patients (32 unresected and 31 resected) who underwent 162 evaluations. The results of the [51CR]EDTA test were compared with the serum levels of the acute-phase reactant proteins (APRP) and with the result of the [111In]leukocyte scanning, respectively, as an indirect and direct method to assess intestinal inflammation. In a group of healthy adult controls, the upper normal value for the 24-hr urinary [51CR]EDTA excretion was 3.61 (97.5% percentile) and the mean coefficient of variation was 21%. Sensitivity and specificity of the [51CR]EDTA test in identifying active inflammation expressed by increased serum levels of APRP were, respectively, 97% and 54% in the unresected group and 68% and 52% in the resected group of patients. The low specificity of the test was due to the presence of increased [51CR]EDTA urinary excretion in about half the cases with normal serum levels of APRP. The [111In]leukocyte scanning was performed in a subgroup of 11 patients (three unresected and eight resected) with normal serum levels of APRP, six with increased and five with normal [51CR]EDTA urinary excretion. All six patients with increased intestinal permeability had a positive 111In image of mild to moderate degree of activity. A positive 111In scan was present in two of the five patients with normal permeability; these were two resected patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Pironi
L
L
Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.
Miglioli
M
M
Ruggeri
E
E
Levorato
M
M
Dallasta
M A
MA
Corbelli
C
C
Nibali
M G
MG
Barbara
L
L
D000209:Acute-Phase Proteins / Q000032:analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002860:Chromium Radioisotopes; D003424:Crohn Disease / Q000378:metabolism*; D004492:Edetic Acid / Q000032:analysis / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism*; D007962:Leukocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010539:Permeability
D000209:Acute-Phase Proteins; D002860:Chromium Radioisotopes; D007205:Indium Radioisotopes; D004492:Edetic Acid