Rapid Communication
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jan 7, 2008; 14(1): 85-89
Published online Jan 7, 2008. doi: 10.3748/wjg.14.85
C-reactive protein levels during a relapse of Crohn’s disease are associated with the clinical course of the disease
Chantal L Koelewijn, Matthijs P Schwartz, Melvin Samsom, Bas Oldenburg
Chantal L Koelewijn, Matthijs P Schwartz, Melvin Samsom, Bas Oldenburg, Department of Gastroenterology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands
Correspondence to: Dr. Bas Oldenburg, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. b.oldenburg@umcutrecht.nl
Telephone: +31-30-2509111
Fax: +31-30-2505533
Received: August 13, 2007
Revised: October 8, 2007
Published online: January 7, 2008

AIM: To explore if C-reactive protein (CRP) levels might serve as a prognostic factor with respect to the clinical course of Crohn’s disease and might be useful for classification.

METHODS: In this retrospective cohort study we enrolled 94 patients from the inflammatory bowel disease (IBD) database of the University Medical Centre Utrecht. CRP levels during relapse were correlated with the number of relapses per year. Severity of relapses was based on endoscopic reports and prednisone use. Furthermore, patients were categorized in a low or high CRP group based on their CRP response during relapse and demographic and clinical features were compared.

RESULTS: Overall, a positive correlation between CRP levels, number of relapses, and severity of relapse was found (respectively rs = 0.31, P < 0.01 and rs = 0.50, P < 0.001). Employing a cut-off level of 15 mg/L, the index CRP level was found to discriminate patients with respect to the number of relapses per year, as well as for severity of relapses (respectively 0.25 ± 0.16 vs 0.36 ± 0.24, P < 0.05 and 4.4 ± 1.2 vs 3.2 ± 1.1 on a 10-point visual analogue scale, P < 0.001 for the high CRP and low CRP groups respectively). In addition, the high CRP group showed more cumulative days of prednisone use per year (107 ± 95 vs 58 ± 48, P < 0.05), as well as a better response to infliximab (93 % vs 33 %, P = 0.06).

CONCLUSION: A higher CRP level during relapse seems to be associated with a more severe clinical course of disease.

Keywords: Crohn’s disease, Infliximab, C-reactive protein, Prognosis, Clinical behaviour