[Changes in cell-mediated immune reactions in Crohn's disease]

In a prospective study the effect on cell-mediated immunity (Mérieux-Multitest), nutritional state and parameters of inflammation was compared in conservatively (n = 21) and surgically (n = 20) treated patients with Crohn's disease. Before therapy both groups showed a significantly lower immune response compared with healthy controls. The therapeutical effect was similar in both groups concerning normalization of parameters of inflammation, CDAI and state of nutrition. In contrast, normalization of immune response in skin test was only observed after bowel resection, while conservatively treated patients remained in hyperergy. In conclusion, the impairment of the cell mediated immunity in Crohn's disease must be secondary. Excluding patients with steroid therapy there was no correlation between preoperative annergy or hyperergy and postoperative complications.