Lemann Index for Assessment of Crohn's Disease: Correlation with the Quality of Life, Endoscopic Disease Activity, Magnetic Resonance Index of Activity and C- Reactive Protein.

Vestina Straksyte,Algidas Basevicius,Gediminas Kiudelis,Irina Gineikiene,Saulius Lukosevicius,Dainius Janciauskas,Limas Kupcinskas

doi:10.1515/med-2019-0092

Vestina Straksyte, Algidas Basevicius + Show 5 more

Open Access

https://doi.org/10.1515/med-2019-0092

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Abstract

AimCrohn’s disease (CD) is characterized by continuing inflammation and progressive gut damage. Despite many scoring indices of CD, there is a lack of more global assessment tools for the evaluation of the total disease impact on the gut.MethodsFift y-three adult patients with proven CD underwent magnetic resonance enterocolonography (MR-EC), colonoscopy, and clinical activity assessment, including CRP. Quality of life was assessed using IBDQ. MR-EC was used to evaluate the Magnetic Resonance Index of Activity (MaRIA- global (G)) and the Lemann Index (LI). The CD Endoscopic Index of Severity (CDEIS) was used to score the endoscopic activity of the disease.ResultsA signifi cant correlation between the LI and IBDQ was found (r=-0.812, P<0.01). LI and MaRIA-G correlated moderately, while the LI did not correlate significantly with CRP and CDEIS. For the detection of endoscopically active CD, MaRIA-G was more sensitive and specific (83.3%; 73.3%) compared to the LI (66.7%; 60.0%). There was a moderate correlation between CRP and MaRIA-G, as well as CRP and CDEIS (r=0.496; r=0.527,<0.01).ConclusionA signifi cant negative correlation between the LI and quality of life, measured by IBDQ, was found in our study, suggesting that the LI could resemble more global features of the disease, besides inflammatory activity of the gut.

Highlights

Crohn’s disease (CD) is an idiopathic, chronic inflammatory bowel disease with an increasing incidence [1]
There was a moderate correlation between C-Reactive Protein (CRP) and Magnetic Resonance Index of Activity (MaRIA)-G, as well as CRP and CD Endoscopic Index of Severity (CDEIS) (r=0.496; r=0.527,
There was no significant correlation between the Lemann Index (LI) and CDEIS, as well as the Inflammatory Bowel Disease Questionnaire (IBDQ) and CDEIS

Summary

Introduction

Crohn’s disease (CD) is an idiopathic, chronic inflammatory bowel disease with an increasing incidence [1]. A distinguishable feature of CD is a transmural intestinal inflammation of the gastrointestinal tract anywhere from the mouth to the anus [2]. CD usually presents early in life and can disturb social life, learning, career, and family planning [3]. Diagnostic delay is common in CD, and the inflammation frequently presents many years before the actual diagnosis is made [4]. A thorough evaluation of the small and large bowel with an optimal diagnostic tool such as magnetic resonance enterocolonography (MR-EC) may lead to the earlier detection of CD phenotype in the most of the patients, especially when the small bowel disease predominates [5]. MR-EC is significant in identifying and managing complications such as fistulas, strictures, and abscesses [2]

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Conclusion