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Erythrocyte Sedimentation Rate: A Physics-Driven Characterization in a Medical Context
Published on: March 24, 2023
Correlation of Erythrocyte Sedimentation Rate and C-Reactive Protein With Pediatric Inflammatory Bowel Disease
Arik Alper1, Lucy Zhang, Dinesh S Pashankar
1Department of Pediatrics, Yale University, New Haven, CT.
Insights
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) showed limited utility in predicting inflammatory bowel disease (IBD) activity in children. Normal values were common at diagnosis, and correlations varied, particularly for Crohn disease.
Area of Science:
- Pediatric Gastroenterology
- Clinical Chemistry
- Inflammatory Bowel Disease Research
Background:
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are commonly used inflammatory markers.
- Their utility in assessing disease activity in pediatric inflammatory bowel disease (IBD) requires further clarification.
Purpose of the Study:
- To investigate the correlation of ESR and CRP with IBD diagnosis.
- To assess the relationship between ESR and CRP and disease activity (clinical, endoscopic, histological, radiographic) during a 5-year follow-up in children with IBD.
Main Methods:
- Retrospective chart review of 135 children diagnosed with IBD.
- Correlation analysis of ESR and CRP values with various disease activity parameters over 5 years.
- Evaluation of diagnostic and follow-up data for Crohn disease and ulcerative colitis.
Main Results:
- Normal ESR and CRP levels were observed in a significant proportion of children at diagnosis (up to 28% for Crohn disease, 42% for ulcerative colitis).
- ESR and CRP correlation with Crohn disease activity depended on initial values and analysis method.
- ESR and CRP were not effective in predicting ulcerative colitis activity or radiographic small bowel Crohn disease during follow-up.
Conclusions:
- ESR and CRP have limited value in diagnosing and monitoring pediatric IBD, especially ulcerative colitis.
- The predictive value of ESR and CRP for Crohn disease activity is inconsistent and depends on baseline levels.
- Alternative biomarkers may be needed for accurate assessment of IBD activity in children.
Abstract:
We aimed to examine correlation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) with diagnosis of inflammatory bowel disease and with clinical, endoscopic, histological, and radiographic disease activity during follow-up. We reviewed charts of 135 children with inflammatory bowel disease and correlated their ESR and CRP values with disease activity in various encounters during 5 years. Normal ESR and CRP values were observed in up to 28% of children with Crohn disease and 42% of children with ulcerative colitis at diagnosis, respectively. Correlation of ESR and CRP with Crohn disease clinical, endoscopic, and histologic activity during follow-up depended on their value at diagnosis and mode of analysis (continuous or dichotomous). Both markers were not useful in predicting clinical, endoscopic, or histologic ulcerative colitis disease activity and radiographic small bowel Crohn disease during follow-up.
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