ENTERIC PROTEIN LOSS, MEASURED BY FECAL ALPHA-1-ANTI-TRYPSIN (AT) CLEARANCE, IN THE ASSESSMENT OF CROHN'S DISEASE ACTIVITY

Abstract

In 63 patients with Crohn's disease, less than 19 yr. of age, we compared conventional measures of disease activity against 24 hr. fecal alpha-1-AT clearance. Clearance was significantly increased in patients with abnormal ESR (>15 mM/hr) but not in those with abnormal Crohn's disease activity index, CDAI, (>150) or increased platelet count (>400,000). As expected, in those with diminished serum albumin levels (<35 g/L), fecal alpha-1-AT clearance was significantly increased.Further analyses did not demonstrate significant correlations between alpha-1-AT clearance and CDAI (r=0.09), platelet count (r=0.13), or ESR (r=0.17). We conclude that severity of enteric protein loss is not closely related to degree of abnormality of commonly used measures of disease activity in young patients with Crohn's disease. However, since available indices of Crohn's activity are of questionable validity, and since an objective index of activity is badly needed for therapeutic trials, further evaluations of fecal alpha-1-AT clearance are warranted in this disease.