Microinflammation in patients with Crohn's disease in clinical remission
Nitsan Maharshak1, Liaz Zilberman, Yaron Arbel
1Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 6 Weizman Street, Tel Aviv, 64239 Israel.
Background And Aims:
It is not clear whether Crohn's disease patients in clinical remission (Crohn's disease activity index<150) display normal concentrations of inflammation sensitive biomarkers. Our goal in this work was to explore the intensity of the microinflammatory response in a group of Crohn's disease patients in clinical remission.
Methods:
High sensitivity C-reactive protein, quantitative fibrinogen, erythrocyte sedimentation rate as well as platelet and leukocyte counts were examined in a group of 76 patients with Crohn's disease in remission and in 228 matched controls.
Results:
Crohn's disease patients in clinical remission displayed a statistically significant (p<0.001) elevated concentration of hs-CRP (4.83±3.8 mg/l) compared to controls (1.05±2.9 mg/l). All other bio-markers were also significantly higher in Crohn's disease patients in remission compared to controls. Similar results were obtained in a subgroup of Crohn's disease patients with very low disease activity - CDAI<75.
Conclusions:
Clinical remission is not equivalent to biochemical remission raising a question concerning the true definition of remission in Crohn's disease.
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