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2019, Cilt 17, Sayı 3, Sayfa(lar) 140-148
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Early Prediction Of Crohn’s Disease Activity In Clinically Remission Patients
Günel Hasanova1, Burcu Barutçuoğlu2, Nalan Gülşen Ünal3, Günes Ak2, Ömer Özütemiz3
1Ege Üniversitesi Tıp Fakültesi, Tıbbi Biyokimya AD., İzmir,Türkiye
2Ege Üniversitesi Tıp Fakültesi, Klinik Biyokimya BD., İzmir,Türkiye
3Ege Üniversitesi Tıp Fakültesi Gastroenteroloji AD., İzmir,Türkiye
Keywords: Crohn’s Disease;calprotectin; lactoferrin

Aim: Crohn's disease (CD) is an immunity-based inflammatory disease of unknown etiology which affects any region of the gastrointestinal tract with transmural involvement. In these patients; many clinical activity indicators and noninvasive markers have been used to assess disease activity, but none have been as accurate as histopathological and endoscopic examinations in detecting inflammatory activity. In CD, disease activity is clinically determined by Crohn's Disease Activity Index (CDAI) score. According to CDAI, less than 150 points is accepted as remission, and over 450 points is a serious fulminant disease. The aim of this study is to predict the CD activity by fecal calprotectin and fecal lactoferrin in clinically remission Crohn's disease patients.

Materials and Methods: Twelve asymptomatic CD patients (CDAI<150), chosen in outpatient Gastroenterology clinics, were included in our study. Serum C reactive protein (CRP), serum amyloid A (SAA), erytrocyte sedimentation rate(ESR), WBC count, fecal calprotectin and fecal lactoferrin were measured. Based on colonoscopy performed within the same week, 5 were in remission and 7 were active CD patients.

Results: Fecal calprotectin, lactoferrin, serum CRP and SAA were significantly higher in active CD than in remission (all p <0.050), but there were no significant diferrence in CDAI, ESR and WBC (all p>0.050). There was significant positive correlation between calprotectin SES/Rutgeerts colonoscopy score indices (r= 0.592, p=0.043) and between lactoferrin SES/Rutgeerts colonoscopy score indices(r=0.720, p=0.008).

Conclusion: In order to chose the candidates to colonoscopy, fecal calprotectin and lactoferrin which reflect mucosal inflammation should be performed.

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