Monitoring of severe Crohn's colitis treated with intravenous corticosteroids by c-reactive protein: results of a prospective study

Background: Monitoring an acute severe ulcerative colitis by C-reactive protein (CRP) have a prognostic impact on management and can predict the outcome of patients. However, the role of CRP as a monitoring tool in severe Crohn's colitis is not established. Aims: To analyse the ability of simple biochemical parameters to predict intravenous glucocorticosteroid (GCS) treatment failure in patients with severe Crohn's colitis; with special interest for the evolution of CRP levels during the first days of treatment. Material and methods: We include prospectively all patients with severe Crohn's colitis, attested by a CDAI over to 450 points associated with endoscopic signs of severity, and treated by intensive intravenous corticosteroids. All patients had a measure of CRP level before and at day 3 after treatment initiation. Therapeutic failure was defined as a lack of clinical remission or need for surgery within the first 15 days of treatment. Results: We include 51 patients (17 men--mean age: 31,7 years). Failure of intensive treatment was observed in 16 cases (31%). Predictive factors for treatment's failure were a low CRP level before treatment (44,46 + 33,4 mg/l vs 116,52 + 83,28 mg/l; p=0,04), absence of decreasing of ESR and CRP levels more than 50% at the third day (respectively 100% vs 15/35: 43%; p=0,001 and 100% vs 2/19: 10%; p Conclusion: Monitoring a severe Crohn's colitis patients with CRP measurement is helpful to predict the unfavourable outcome and to select the patients in whom a more aggressive medical treatment should be considered at an early stage. Keywords: Crohn's disease, C-reactive protein
Table of Contents Abstract Introduction Material And Methods Results Discussion References Introduction Intravenous corticosteroid is the first line treatment of acute severe colitis in Crohn's disease (1). Recently, treatment by [...]