title: Evaluation of disease activity in IBD at the time of diagnosis by the use of clinical, biochemical, and fecal markers.
abstract: OBJECTIVE
  The present population based adult cohort was part of a new prospective study of patients with inflammatory bowel disease (IBD) in South-Eastern Norway, the Inflammatory Bowel South-Eastern Norway II study, investigating disease characteristics in an attempt to improve our knowledge regarding factors related to early clinical phenotype and disease activity.
  
  
  METHODS
  Patients suspected to have IBD on the basis of predefined symptoms, including abdominal pain, diarrhea, and/or blood in stool for more than 10 days were examined at the local hospital. Colonoscopy with biopsies was performed and blood and stool samples were taken.
  
  
  RESULTS
  In ulcerative colitis (UC) patients, the median Simple Clinical Colitis Activity Index (SCCAI) was 4 (range 0-10) in mild and 6 (range 0-14) in patients with moderate or severe endoscopic activity of inflammation (p = 0.002). The calprotectin concentration in feces was significantly related to the SCCAI (p = 0.034) and the Mayo endoscopic subscore (p = 0.031). There was a significant association between the C-reactive protein (CRP) value, leucocytes and thrombocytes and the SCCAI, but only leucocytes were significantly associated with the Mayo endoscopic subscore. In Crohn's disease (CD) patients, there was no statistical significant association between the Harvey-Bradshaw Index (HBI) and the endoscopic grade of mucosal inflammation (p = 0.8). The calprotectin concentration in feces was significantly related to the endoscopic activity score (p = 0.004), but not to the HBI (p = 0.5). HBI was significantly related to the CRP value (p = 0.047) and thrombocytes (p = 0.03).
  
  
  CONCLUSIONS
  In UC, both biochemical and fecal markers are related to disease activity and extent of disease, whereas in CD, the fecal calprotectin concentration is a reliable marker of mucosal affection, but not for systemic disease activity.
authors: Department of Gastroenterology, Akershus University Hospital, Lørenskog, Norway. petr.ricanek@medisin.uio.no
authors: Petr
authors: P
authors: Ricanek
authors: Stephan
authors: S
authors: Brackmann
authors: Gøri
authors: G
authors: Perminow
authors: Lars G
authors: LG
authors: Lyckander
authors: Jon
authors: J
authors: Sponheim
authors: Oyvind
authors: O
authors: Holme
authors: Ole
authors: O
authors: Høie
authors: Andreas
authors: A
authors: Rydning
authors: Morten H
authors: MH
authors: Vatn