Biological and histological parameters as predictors of relapse in ulcerative colitis: A prospective study
Open Access
- 1 January 2011
- journal article
- research article
- Published by Medknow in Saudi Journal of Gastroenterology
- Vol. 17 (3), 194-8
- https://doi.org/10.4103/1319-3767.80383
Abstract
Background/Aim: Ulcerative colitis is a chronic inflammatory disease of unknown etiology characterized by periods of remission and relapses. This study has been carried out in a group of North Indian patients, where the disease has shown an increasing prevalence and frequent relapses. Hence, there is a need to predict relapse for better management and to reduce morbidity. To assess the importance of biological and histological parameters in predicting relapse when the disease is in quiescent phase. Materials and Methods: A prospective study of twenty-six patients with quiescent ulcerative colitis was carried out in Dayanand Medical College and Hospital,Punjab. Only patients with clinical and endoscopic remission at the time of screening visit were included. Hemoglobin, erythrocyte sedimentation rate (ESR), C- reactive protein (CRP) and serum Interleukin-6 (IL-6) levels were measured. The baseline colonoscopic mucosal biopsies were retrieved and studied. Follow-up was conducted for one year at monthly interval or earlier if relapse occurred. Results: Fifteen out of twenty-six patients (57.69%) had evidence of clinical relapse during the follow-up. Hemoglobin, ESR, CRP and IL-6 levels were not found to be significant predictors of relapse. Increased number of eosinophils and neutrophils in the lamina propria were observed to be associated with significantly higher relapse rate. Conclusion: A higher risk of relapse in patients with quiescent colitis can be predicted by the presence of increased number of eosinophils and neutrophils in the lamina propria.Keywords
This publication has 17 references indexed in Scilit:
- Incidence and prevalence of ulcerative colitis in Punjab, North IndiaGut, 2003
- A reproducible grading scale for histological assessment of inflammation in ulcerative colitisGut, 2000
- Clinical Course during the 1st Year after Diagnosis in Ulcerative Colitis and Crohn's Disease: Results of a Large, Prospective Population-based Study in Southeastern Norway, 1990-93Scandinavian Journal of Gastroenterology, 1997
- Why do patients with ulcerative colitis relapse?Gut, 1990
- The biology of interleukin-6.1989
- Peptide Regulatory Factors: CACHECTIN/TUMOUR NECROSIS FACTORThe Lancet, 1989
- The role of sigmoidoscopy and rectal biopsy in diagnosis and management of inflammatory bowel disease: personal experience.1988
- Rectal biopsy helps to distinguish acute self-limited colitis from idiopathic inflammatory bowel diseaseGastroenterology, 1984
- Measurement of serum proteins during attacks of ulcerative colitis as a guide to patient management.Gut, 1979
- Serial rectal biopsy in ulcerative colitis during the course of a controlled therapeutic trial of various dietsDigestive Diseases and Sciences, 1966