INCREASED LEUKOCYTE ADHESIVENESS AGGREGATION IS A MOST USEFUL INDICATOR OF DISEASE-ACTIVITY IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE/

The aim of the study was to determine the comparative usefulness of in flammatory markers, in evaluating disease activity in patients with in flammatory bowel disease. Disease activity was assessed by the Mayo Cl inic score for ulcerative colitis, and Harvey-Bradshaw score for Crohn 's disease. Five hundred normal blood donors who had no underlying inf lammatory condition served as controls. The erythrocyte sedimentation rate, platelet and white blood cell count, C reactive protein, and the leucocyte adhesiveness/aggregation test (LAAT) were determined in eac h patient. One hundred and twenty four patients with inflammatory bowe l disease were tested while in remission and 128 in relapse. Their mea n (SD) per cent of aggregated white blood cells in the peripheral bloo d was 8 (5) and 17 (10) respectively compared with controls 6 (4) (p < 0.0001). Moreover, the LAAT could effectively discriminate between va rious grades of disease activity, the values in patients with active d isease being 13 (6)% in mild, 17 (10)% in moderate, and 26 (10)% in se vere disease (p < 0.0001). Other acute phase reactants including the e rythrocyte sedimentation rate, the white blood cell count, the platele t count, neutrophil count, as well as, the C reactive protein concentr ation did not differentiate as well between the various groups. Using logistic regression analysis to differentiate between inflammatory bow el disease patients in remission or relapse, the LAAT was the single b est indicator. The addition of any other test did not contribute to th e discrimination. Among the different laboratory variables tested only between the five different subgroups of controls, remission and mild, moderate or severe disease activity.