Relationship of inflammation and hemogram parameters in the activation of inflammatory bowel diseases

Abstract

Aim: The evaluation of inflammatory bowel diseases (IBD) is based on a combination of clinical examination, laboratory marker and colonoscopic findings. There is no any gold standard test and cost effective, easy applicable markers are required. This present study aimed is determined the relationship between inflamation parameters and hemogram parameters in the IBD. Material and Method: The present study included patients at ≥18 years of age with IBD, who presented between January 2010 and December 2015 and medical records of all patients were retrospectively assessed. Chron Disease (CH) Activity Index for the assessment of activity of CH and SEO Clinical Activity Index for the assessment of activity of ulserative colitis (UC) were used. Additionally, hemogram, C-reactive protein (CRP) and eritrosit sedimentation rate (ESR) of all patients were evaluated. Results: In this study 74 (39.57%) patients with the CD group and 113 (60.43%) patients with the UC group and total of 187 patients with IBD included. Twenty nine (39.19%) patients with CD and 42 (37.17%) patients with UC were in activation period. The platelet count and RDW were found to increase in the activation period of both disease (p=0.001 and p=0.0001 for CD; p=0.001 and p=0.0001 for UC, respectively). In remission period, while there were positive relationship CRP and ESR with platelet counts in the CD group, the positive relationship CRP with leucocyte count was found in the UC group. (p=0.025, p=0.044 and p=0.003 respectively). In the activation period, there were associated CRP and ESR with RDW in the UC group and the correlation between CRP with platelet count in the CD group was determined (p=0.015, p=0.019, and p=0.025, respectively). Conclusion: Platelet count and level of RDW in the hemogram parameters, which a cost effective method for clinical practice, increase in the activation period of CD and UC. / Aim: The evaluation of inflammatory bowel diseases (IBD) is based on a combination of clinical examination, laboratory marker and colonoscopic findings. There is no any gold standard test and cost effective, easy applicable markers are required. This present study aimed is determined the relationship between inflamation parameters and hemogram parameters in the IBD. Material and Method: The present study included patients at ≥18 years of age with IBD, who presented between January 2010 and December 2015 and medical records of all patients were retrospectively assessed. Chron Disease (CH) Activity Index for the assessment of activity of CH and SEO Clinical Activity Index for the assessment of activity of ulserative colitis (UC) were used. Additionally, hemogram, C-reactive protein (CRP) and eritrosit sedimentation rate (ESR) of all patients were evaluated. Results: In this study 74 (39.57%) patients with the CD group and 113 (60.43%) patients with the UC group and total of 187 patients with IBD included. Twenty nine (39.19%) patients with CD and 42 (37.17%) patients with UC were in activation period. The platelet count and RDW were found to increase in the activation period of both disease (p=0.001 and p=0.0001 for CD; p=0.001 and p=0.0001 for UC, respectively). In remission period, while there were positive relationship CRP and ESR with platelet counts in the CD group, the positive relationship CRP with leucocyte count was found in the UC group. (p=0.025, p=0.044 and p=0.003 respectively). In the activation period, there were associated CRP and ESR with RDW in the UC group and the correlation between CRP with platelet count in the CD group was determined (p=0.015, p=0.019, and p=0.025, respectively). Conclusion: Platelet count and level of RDW in the hemogram parameters, which a cost effective method for clinical practice, increase in the activation period of CD and UC.Amaç: İnflamatuar barsak hastalığı (İBH)’nın değerlendirilmesiklinik muayene, laboratuar belirteçleri ve kolonoskopik bulgularadayalıdır. Herhangi bir altın standart test yoktur ve maliyet etkin,kolay uygulanabilir belirteçler gereklidir. Bu çalışmada İBH’da inflamasyonparametreleri ile hemogram parametrelerinin ilişkisinindeğerlendirilmesi amaçlanmaktadır.Materyal ve Metot: Bu çalışmaya 18 yaş ve üzeri İBH olan, Ocak 2010Aralık 2015 arasında başvuran hastalar dahil edilmiş ve tüm hastalarıntıbbi kayıtları geriye dönük olarak değerlendirilmiştir. Crohn hastalığı(CH) aktivite indeksi CH’nın aktivitesini değerlendirmek için ve SEOklinik aktivasyon indeksi ise ülseratif kolit (ÜK)’nın aktivitesini değerlendirmekiçin kullanılmıştır. Ayrıca tüm hastaların hemogram, C-reaktifprotein (CRP) ve eritrosit sedimentasyon hızı (ESH) değerlendirilmiştir.Bulgular: Çalışmaya 74 (%39,57) CH grubunda, 113 (%60,43) ÜKgrubunda olmak üzere toplam 187 İBH hastası dahil edilmiştir. CH’ıolan hastaların 29 (%39,19)’u ve ÜK olan hastaların 42 (%37,17)’iaktivasyon döneminde idi. Aktivasyon döneminde her iki gruptada trombosit sayısı ve RDW’de artış saptandı (sırasıyla, CD içinp=0,001 ve p=0,0001; ÜK için p=0,001 ve p=0,0001). Remisyondöneminde, CH grubunda CRP ve ESH ile trombosit sayısı arasındapozitif ilişki mevcutken, ÜK grubunda CRP ile lökosit sayısı arasındaanlamlı pozitif ilişki saptanmıştır (sırasıyla, p=0,025, p=0,044ve p=0,003). Aktivasyon döneminde, ÜK grubunda CRP ve ESR ileRDW arasında ilişki mevcut olup, CH grubunda CRP ile trombositsayısı arasında korelasyon tespit edilmiştir.Sonuç: Klinik pratikte maliyet etkin bir yöntem olan hemogramparametrelerinden trombosit sayısı ve RDW düzeyi CH ve ÜK’inaktivasyon döneminde artmaktadır.