Enteric protein loss measured by fecal alpha 1-antitrypsin clearance in the assessment of Crohn's disease activity: a study of children and adolescents.
We compared conventional measures of disease activity with 24-h fecal alpha 1-antitrypsin clearance in 59 children and adolescents with Crohn's disease and 30 with ulcerative colitis. Among the Crohn's patients clearance was increased significantly in those with abnormal erythrocyte sedimentation rates (ESR) (greater than 15 mm/h, p less than 0.005) and diminished serum albumin (less than 35 g/L, p less than 0.005), but not in those with an abnormal Crohn's disease activity index (CDAI less than 150). Correlation between alpha 1-antitrypsin clearance and ESR was poor (r = 0.17) as with CDAI (r = 0.09). We conclude that severity of enteric protein loss is not closely related to the degree of abnormality of commonly used measures of disease activity in young patients with Crohn's disease. In contrast, in patients with ulcerative colitis, alpha 1-antitrypsin clearance correlated more consistently with clinical assessment of inflammatory activity (p less than 0.001).
D000293:Adolescent; D001799:Blood Sedimentation; D002648:Child; D003093:Colitis, Ulcerative / Q000378:metabolism; D003424:Crohn Disease / Q000378:metabolism*; D005243:Feces / Q000032:analysis*; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D008657:Metabolic Clearance Rate; D011506:Proteins / Q000378:metabolism*; D012044:Regression Analysis; D012709:Serum Albumin / Q000032:analysis; D000515:alpha 1-Antitrypsin / Q000378:metabolism*
D011506:Proteins; D012709:Serum Albumin; D000515:alpha 1-Antitrypsin