IDDF2019-ABS-0346 Utility of inflammatory markers in the management of inflammatory bowel disease and their correlation with disease activity indices

Abstract

Background Inflammatory bowel disease (IBD) is increasing in India. Clinical expressions of IBD are many & disease behaviour varies among populations. Various inflammatory markers are useful in monitoring disease activity and modifying therapy. Present study aims to assess the severity of IBD by disease activity indices - Mayo Score & Crohn’s Disease Activity Index (CDAI) and to find their correlation with inflammatory markers. Methods IBD patients including both Ulcerative Colitis (UC) & Crohn’s Disease (CD) were interviewed and their medical records were reviewed for the required details. Inflammatory markers - Complete Blood Count, Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Albumin & Fecal Calprotectin (FC) were checked by the standardized laboratory assay. The disease activity scores were calculated using online calculator - www.gihep.com. Results Among total 110 IBD patients, 56 (51%) had CD & 54 (49%) had UC. CD patients were younger than UC (34.8 vs 51 years, p 0.05). CD patients had significantly high CRP (p=0.01). No correlation was noted between inflammatory markers like - ESR & Platelet count with activity indices - Mayo Score (r = 0.01, r= -0.008) and CDAI (r= -0.07, r=0.002) respectively, while CRP showed trend towards positive correlation (r= 0.1, r= 0.2) though not significant, (p>0.05). FC correlated well with disease activity in UC better than in CD (r= 0.8, r= 0.6) respectively. FC (>250 mcg/g) predicted early relapse with 80% accuracy. Conclusions CRP is better inflammatory marker than ESR & Platelet count. Fecal Calprotectin has good diagnostic presssion in assessing disease activity & predicting an early relapse.