title: Faecal analysis and plasma complement factor 3c levels at admission for an acute attack of ulcerative colitis are predictive of the need for colectomy.
abstract: BACKGROUND
  Ulcerative colitis is a chronic inflammation limited to the large bowel. Early identification of reliable predictive markers addressing the risk of need for colectomy in a severe attack of ulcerative colitis is of crucial importance.
  
  
  OBJECTIVE
  To evaluate faecal characteristics and peripheral blood tests as predictive markers for subsequent risk of colectomy in a severe attack of ulcerative colitis.
  
  
  METHODS
  This was an observational study. Samples were collected in a cohort of 18 patients with a severe attack of ulcerative colitis. A panel of selected variables was evaluated (faecal characteristics, peripheral blood samples including complement factor 3c, circulating cytokines and antisecretory factor) for ability to predict colectomy. The patients were observed for up to 58 months (median 37.5, range 0.5-58 months) and allocated to one of two groups depending on the clinical outcome on the basis of the need for colectomy.
  
  
  RESULTS
  Seven patients underwent colectomy. The present study showed a positive correlation between increased bowel movements (P=0.01), faecal weight/bowel movement (P=0.03) and complement factor 3c levels (P=0.01) and a need for later colectomy. None of the other laboratory markers investigated were shown to be predictive of risk for later colectomy.
  
  
  CONCLUSIONS
  Early faecal analysis and measurement of complement factor 3c may be useful as predictive markers of the need for colectomy related to a severe attack of ulcerative colitis.
authors.affiliation: aDepartment of Internal Medicine and Geriatrics, Sahlgrenska University Hospital/Östra Hospital bInstitute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Göteborg cDepartment of Gastroenterology and Hepatology, Division of Gastroenterology, Karolinska Institute, Karolinska University Hospital dDepartment of Dental Medicine, Division of Periodontology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Pagoldh
authors.forename: Stefan
authors.initials: S
authors.lastname: Lange
authors.forename: Eva
authors.initials: E
authors.lastname: Jennische
authors.forename: Sven
authors.initials: S
authors.lastname: Almer
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Boström
authors.forename: Anders
authors.initials: A
authors.lastname: Eriksson
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D003113:Colonoscopy; D015932:Complement C3c / Q000032:analysis*; D003672:Defecation / Q000502:physiology; D005243:Feces / Q000737:chemistry*; D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015932:Complement C3c