Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease

Craig A. Solem, Edward Vincent Loftus, Jr, William J. Tremaine, William S. Harmsen, Alan R. Zinsmeister, William J. Sandborn

Research output: Contribution to journalArticle

379 Citations (Scopus)

Abstract

Introduction: We sought to examine the relationship between C-reactive protein (CRP) and clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease (IBD). Methods: All IBD patients at our institution between January 2002 and August 2003 who had a CRP, colonoscopy, and either small bowel follow-through (SBFT) or CT enterography (CTE) performed within 14 days were identified. Clinical activity was assessed retrospectively through review of the medical record. Logistic regression was used in Crohn's disease (CD) patients to estimate the odds ratio (OR) with 95% confidence intervals for an elevated CRP. Associations were assessed using Fisher exact test in ulcerative colitis (UC) patients due to small sample size. Results: One-hundred four CD patients (46% males) and 43 UC and indeterminate colitis patients (44% males) were identified. In CD patients, moderate-severe clinical activity (OR, 4.5; 95% CI, 1.1-18.3), active disease at colonoscopy (OR, 3.5; 95% CI, 1.4-8.9), and histologically severe inflammation (OR, 10.6; 95% CI; 1.1-104) were all significantly associated with CRP elevation. Abnormal small bowel radiographic imaging was not significantly associated with CRP elevation. In UC patients, CRP elevation was significantly associated with severe clinical activity, elevation in sedimentation rate, anemia, hypoalbuminemia, and active disease at ileocolonoscopy, but not with histologic inflammation. Conclusions: CRP elevation in IBD patients is associated with clinical disease activity, endoscopic inflammation, severely active histologic inflammation (in CD patients), and several other biomarkers of inflammation, but not with radiographic activity.

Original languageEnglish (US)
Pages (from-to)707-712
Number of pages6
JournalInflammatory Bowel Diseases
Volume11
Issue number8
DOIs
StatePublished - Aug 2005

Fingerprint

Inflammatory Bowel Diseases
C-Reactive Protein
Crohn Disease
Inflammation
Odds Ratio
Ulcerative Colitis
Colonoscopy
Hypoalbuminemia
Colitis
Sample Size
Medical Records
Anemia
Biomarkers
Logistic Models
Confidence Intervals

Keywords

  • C-reactive protein
  • Crohn's disease
  • Erythrocyte sedimentation rate
  • Inflammatory bowel disease

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease. / Solem, Craig A.; Loftus, Jr, Edward Vincent; Tremaine, William J.; Harmsen, William S.; Zinsmeister, Alan R.; Sandborn, William J.

In: Inflammatory Bowel Diseases, Vol. 11, No. 8, 08.2005, p. 707-712.

Research output: Contribution to journalArticle

Solem, Craig A. ; Loftus, Jr, Edward Vincent ; Tremaine, William J. ; Harmsen, William S. ; Zinsmeister, Alan R. ; Sandborn, William J. / Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease. In: Inflammatory Bowel Diseases. 2005 ; Vol. 11, No. 8. pp. 707-712.
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