Klinik Remisyonda olan Crohn Hastalarında Hastalık Aktivitesinin Erken Öngörüsü
Küçük Resim Yok
Tarih
2019
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Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Crohn’s hastalığı (CH) gastrointestinal sistemin herhangi bir bölgesinde transmural tutulumu olan, etyolojisi bilinmeyen, immunite kökenli inflamatuvar bir hastalıktır. Bu hastalarda hastalık aktivitesini saptamak için birçok klinik aktivite indikatörü ve invazif olmayan göstergeler kullanılmıştır ancak, hiçbiri histopatolojik ve endoskopik incelemeler kadar doğru olmamaktadır. CH’nda, hastalık aktivitesi klinik olarak Crohn’s Hastalığı Aktivite indeksi (CDAI) ile saptanmaktadır. CDAI’e göre 150 puanın altı remisyon ve 450 puan üzeri ciddi fulminan hastalık olarak kabul edilmektedir. Bu çalışmanın amacı klinik remisyondaki CH’da hastalık aktivitesini fekal kalprotektin ve fekal laktoferrin ile öngörmektir. Gereç ve Yöntem: Gastroenteroloji polikliniğe başvurulan on iki asemptomatik CH’sı (CDAI<150) çalışmamıza dahil edildi. Serum C-reaktif protein (CRP), serum amiloid A (SAA), eritrosit sedimantasyon hızı (ESH), lökosit sayımı, fekal kalprotektin ve fekal laktoferrin ölçüldü. Aynı hafta içinde yapılan kolonoskopilerine göre, 5 hasta remisyonda, 7 hasta aktif CH idi. Bulgular: Aktif CH’da, fekal kalprotektin, laktoferrin, serum CRP ve SAA (hepsi p<0.050), remisyondakilere göre belirgin olarak daha yüksek olup, CDAI, ESH ve lökosit sayıları için anlamlı fark saptanmadı (hepsi p>0.050). Kalprotektinle SES/Rutgeerts kolonoskopi skor indeksleri (r= 0.592, p=0.043) arasında ve laktoferrinle SES/Rutgeerts kolonoskopi skor indeksleri (r=0.720, p=0.008) arasında anlamlı pozitif korelasyon saptandı. Sonuç: Mukozal inflamasyonu yansıtan fekal kalprotektin ve laktoferrin kolonoskopiye aday hastaları seçebilmek için mutlaka ölçülmelidir.
Aim: Crohn's disease (CD) is an immunity-based inflammatory disease of unknown etiology which affects any region of the gastrointestinal tract with transmural involvement. in these patients; many clinical activity indicators and noninvasive markers have been used to assess disease activity, but none have been as accurate as histopathological and endoscopic examinations in detecting inflammatory activity. in CD, disease activity is clinically determined by Crohn's Disease Activity Index (CDAI) score. According to CDAI, less than 150 points is accepted as remission, and over 450 points is a serious fulminant disease. the aim of this study is to predict the CD activity by fecal calprotectin and fecal lactoferrin in clinically remission Crohn's disease patients. Materials and Methods: Twelve asymptomatic CD patients (CDAI<150), chosen in outpatient Gastroenterology clinics, were included in our study. Serum C reactive protein (CRP), serum amyloid A (SAA), erytrocyte sedimentation rate(ESR), WBC count, fecal calprotectin and fecal lactoferrin were measured. Based on colonoscopy performed within the same week, 5 were in remission and 7 were active CD patients. Results: Fecal calprotectin, lactoferrin, serum CRP and SAA were significantly higher in active CD than in remission (all p <0.050), but there were no significant diferrence in CDAI, ESR and WBC (all p>0.050). There was significant positive correlation between calprotectin SES/Rutgeerts colonoscopy score indices (r= 0.592, p=0.043) and between lactoferrin SES/Rutgeerts colonoscopy score indices(r=0.720, p=0.008). Conclusion: in order to chose the candidates to colonoscopy, fecal calprotectin and lactoferrin which reflect mucosal inflammation should be performed
Aim: Crohn's disease (CD) is an immunity-based inflammatory disease of unknown etiology which affects any region of the gastrointestinal tract with transmural involvement. in these patients; many clinical activity indicators and noninvasive markers have been used to assess disease activity, but none have been as accurate as histopathological and endoscopic examinations in detecting inflammatory activity. in CD, disease activity is clinically determined by Crohn's Disease Activity Index (CDAI) score. According to CDAI, less than 150 points is accepted as remission, and over 450 points is a serious fulminant disease. the aim of this study is to predict the CD activity by fecal calprotectin and fecal lactoferrin in clinically remission Crohn's disease patients. Materials and Methods: Twelve asymptomatic CD patients (CDAI<150), chosen in outpatient Gastroenterology clinics, were included in our study. Serum C reactive protein (CRP), serum amyloid A (SAA), erytrocyte sedimentation rate(ESR), WBC count, fecal calprotectin and fecal lactoferrin were measured. Based on colonoscopy performed within the same week, 5 were in remission and 7 were active CD patients. Results: Fecal calprotectin, lactoferrin, serum CRP and SAA were significantly higher in active CD than in remission (all p <0.050), but there were no significant diferrence in CDAI, ESR and WBC (all p>0.050). There was significant positive correlation between calprotectin SES/Rutgeerts colonoscopy score indices (r= 0.592, p=0.043) and between lactoferrin SES/Rutgeerts colonoscopy score indices(r=0.720, p=0.008). Conclusion: in order to chose the candidates to colonoscopy, fecal calprotectin and lactoferrin which reflect mucosal inflammation should be performed
Açıklama
Anahtar Kelimeler
0-Belirlenecek
Kaynak
Türk Klinik Biyokimya Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
17
Sayı
3
