Polymorphonuclear leukocyte-elastase in Crohn's disease - Correlation with99(m)Technetium hexamethyl propylene amine grime leukocyte scintigraphy

In Crohn's disease (CD), labeled leukocyte scintigraphy results are highly correlated with radioendoscopic findings and the degree of histologic infla mmation. We evaluated the correlation between leukocyte activity measured b y two complementary methods, polymorphonuclear leukocyte (PMN)-elastase con centration and leukocyte scintigraphy. In 20 patients with CD, labeled leuk ocytes, (99m)technetium hexamethyl propylene amine oxime (Tc-99m-HMPAO) sci ntigraphy, and PMN-elastase concentration were evaluated on the same day. A good correlation was found between PMN-elastase concentrations and the sci ntigraphic scores (p = 0.005; r(s) = 0.60; 95% CI, 0.20-0.83). Scintigraphy results were significantly correlated with CD activity index (p = 0.023, r (s) = 0.50). In four patients, scintigraphic scores and clinical disease ac tivity were not consistent due to the state of PMN leukocyte activation, me asured by elastase concentration. In CD, PMN-elastase can provide informati on about the degree of activation of PMN leukocytes and may explain discrep ancy between clinical and scintigraphic indexes.