Serum Amyloid A as a Surrogate Marker for Mucosal and Histologic Inflammation in Patients with Crohn’s Disease

Abstract

Abstract Background Inflammatory bowel disease (IBD) comprises a heterogeneous group of conditions affecting the gastrointestinal tract; Crohn’s disease (CD) and ulcerative colitis (UC) are the two main recognize dentities. Aim of the Work The aim of the study is to assess the correlation between Serum Amyloid A and mucosal inflammation in patients with Crohn’s disease Patients and Methods This study a prospective cross-sectional single centered study which was carried out on CD patients sought medical advice at Ain Shams outpatient clinics. Results Our results showed highly significant relation between SAA and most of symptoms namely fever, abdominal pain, blood in stool, tenesmus, urgency and number of bowel movements. However, there was no statistically significant relation to weight loss. It worth mention that the relation between SAA levels and history of smoking had borderline statistical significance, while the relation to gender was not statistically significant. Finally, our results showed the sentivity of the major studied markers to detect active CD namely SAA, CRP and Calprotectin was 87.9%, 78.8% and 81% respectively while their specificity was 87.9%, 97% and 60% respectively. SAA was the overall best performing biomarker for CD activity in the current results. Conclusion We concluded that: SAA levels are always significantly higher in patients with CD activity. SAA levels correlate well with all clinical and laboratory signs of CD activity. SAA has an overall accepted sensitivity and specificity which is compared to CRP and fecal calprotectin. Despite higher sensitivity and specificity, using SAA alone as a marker of activity may not achieve a satisfactory diagnostic performance. It's better to be used in combination with other biomarkers.