CORRELATIONS BETWEEN CLINICAL ACTIVITY, ENDOSCOPIC SEVERITY, AND BIOLOGICAL PARAMETERS IN COLONIC OR ILEOCOLONIC CROHNS-DISEASE - A PROSPECTIVE MULTICENTER STUDY OF 121 CASES

The relationships between clinical activity, endoscopic severity, and biological parameters in Crohn's disease have not been thoroughly inve stigated and a link was therefore sought between these three elements. The following parameters were determined simultaneously in 121 consec utive patients with colonic or ileocolonic Crohn's disease: Crohn's di sease activity index, Crohn's disease endoscopic index of severity, an d serum albumin, alpha(2)-globulin, alpha(1)-antitrypsin, orosomucoid, C reactive protein, erythrocyte sedimentation rate, platelets, lympho cyte and polymorphonuclear cell counts, haematocrit, and faecal alpha( 1)-antitrypsin concentration. The distribution of these parameters was studied and transformation was used so that data matched the normal d istribution closely. A weak but significant correlation (r=0.32; p<0.0 01) was found between clinical and endoscopic indices in the whole gro up of patients and this correlation seemed to be homogenous in various patient subgroups (clinically quiescent or active disease, pure colon ic disease, untreated patients). Endoscopic or clinical indices were a lso found to be weakly linked with biological parameters (r<0.50). Ste pwise linear regression identified C reactive protein as predictive of the clinical index, and, successively, alpha(2)-globulin, erythrocyte sedimentation rate, faecal alpha(1)-antitrypsin, serum orosomucoid, a nd alpha(1)-antitrypsin as predictive of the endoscopic index. Both pr edictions were poor - the biological variables accounting for only 22 and 44% respectively of the clinical and endoscopic index variations. In conclusion, Crohn's disease clinical activity seems to be virtually independent of the severity of the mucosal lesions and biological act ivity.